Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-12-30
- Stop
- 2022-12-30
The parties
- Patient
- patient Guy Bode
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
2dc32e32-aee2-84c4-6ca0-6042d79e23b7