Claim total
$651.56
base $93.83 · payer covered $501.56
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1952-04-05
- Stop
- 1952-04-05
The parties
- Patient
- patient Francisco Barton Beahan
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
11955095-c3cb-a03d-62a4-7723f4ce31f6