Claim total
$1,449.77
base $93.83 · payer covered $1,393.16
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-11-23
- Stop
- 2008-11-23
The parties
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
32e00f15-89ac-2f36-99f4-d6722071c8f5