Claim total
$1,052.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-09-04
- Stop
- 2008-09-04
The parties
- Patient
- patient Romeo Emerson Bahringer
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
Record id
34fa854a-89f0-50dc-ec90-bc5416584564