Claim total
$1,004.49
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2008-09-21
- Stop
- 2008-09-21
The parties
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
Record id
1d976b23-0166-2107-212d-c7aee9eeb7ea