Claim total
$1,226.42
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-03-21
- Stop
- 2023-03-21
The parties
- Patient
- patient Beverley Kattie Keebler
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
0cb24d24-cb62-5e83-78b0-93f2b64cd089