Claim total
$978.49
base $93.83 · payer covered $596.38
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-05
- Stop
- 2018-10-05
The parties
- Patient
- patient Cassi Latoya Hilpert
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
11c79940-311a-7715-1ca4-ce3b574ddf9c