Claim total
$838.28
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-03-27
- Stop
- 2007-03-28
The parties
- Patient
- patient Caitlyn Elli Kuhlman
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
0037332a-29d1-a298-6d3a-208f3b792804