Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-01-05
- Stop
- 1983-01-05
The parties
- Patient
- patient Robbyn Tyesha Lynch
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
1fca128b-2fe3-7e2a-f782-5041216a0ee0