Claim total
$1,654.11
base $93.83 · payer covered $1,140.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-10-07
- Stop
- 2003-10-08
The parties
- Patient
- patient Forrest Heath Bailey
- Provider
- provider Roslyn Reichel
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
3595a261-a367-4bc4-32a7-92717b80803a