Claim total
$1,185.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-03-05
- Stop
- 2006-03-05
The parties
- Patient
- patient Etta Daugherty
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
1b5eead1-789b-3423-ecc6-5618e2024c58