Claim total
$880.39
base $93.83 · payer covered $730.39
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1998-11-19
- Stop
- 1998-11-19
The parties
- Patient
- patient Fredric Morar
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
18236d51-ba17-e04c-ceb0-1f1b73847baa