Claim total
$773.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-08-03
- Stop
- 2019-08-03
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-e089-6fd8-71b1f8dc0c56