Claim total
$767.69
base $93.83 · payer covered $430.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-12-25
- Stop
- 2019-12-25
The parties
- Patient
- patient Annmarie Norine Kling
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
1f1c070f-74f1-05e1-bd5b-d8a41054a2ae