Claim total
$1,049.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-07-10
- Stop
- 1984-07-10
The parties
- Patient
- patient Howard Gregory Koch
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer UnitedHealthcare
Record id
2ec30b36-a246-6bf9-f4dd-c868768ee566