Claim total
$906.71
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-04-25
- Stop
- 2000-04-25
The parties
- Patient
- patient Beverley Kattie Keebler
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
0cb24d24-cb62-5e83-82b1-faef3f07ca61