Claim total
$498.76
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1966-06-21
- Stop
- 1966-06-21
The parties
- Patient
- patient Luis Harry Rowe
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
3277736d-dd8f-7874-8eaf-ccb22b5b52cb