Claim total
$1,666.03
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-08-31
- Stop
- 2011-08-31
The parties
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
Record id
1bbb5437-0079-7cbc-aca3-60ef36bdf452