Claim total
$1,049.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-04-07
- Stop
- 1998-04-07
The parties
- Patient
- patient Jan Cliff Johnson
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
085b5e58-fc26-ce3b-14a7-f1e70d76d6f0