Claim total
$840.41
base $93.83 · payer covered $740.41
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2009-07-23
- Stop
- 2009-07-23
The parties
- Patient
- patient Joe Prosacco
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
287ddddc-e201-5785-b91c-eb3d09f8dbf7