Claim total
$1,666.03
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-01-04
- Stop
- 1996-01-04
The parties
- Patient
- patient Gisela Rosalyn Schulist
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
184d403d-a1ec-6f40-5808-abca7ebea0de