Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1993-03-09
- Stop
- 1993-03-09
The parties
- Patient
- patient Jan Cliff Johnson
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
085b5e58-fc26-ce3b-59ea-f838bc6375cf