Claim total
$694.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-06-15
- Stop
- 2021-06-15
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-a298-9945-86187a5a403f