Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-04-08
- Stop
- 2012-04-08
The parties
- Patient
- patient Berry Cody Steuber
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
2bbd0974-5a0c-5ea0-e4cc-c1a7a3fdd8cc