Claim total
$903.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-04-15
- Stop
- 2008-04-15
The parties
- Patient
- patient Catharine Many Nolan
- Provider
- provider Celsa Bailey
- Care site
- care site INDEPENDENT MEDICAL CLINIC PA
- Payer
- payer Anthem
Record id
03cbffbc-74a2-befb-c13e-d05e5bec90ba