Claim total
$1,248.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-02-03
- Stop
- 2024-02-03
The parties
- Patient
- patient Seymour Lyle Kuhlman
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Cigna Health
Record id
000cb105-0f6a-e089-3005-fe2b4f267d96