Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-04-27
- Stop
- 2021-04-27
The parties
- Patient
- patient Catharine Many Nolan
- Provider
- provider Todd Marks
- Care site
- care site INDEPENDENT MEDICAL CLINIC PA
- Payer
- payer Cigna Health
Record id
03cbffbc-74a2-befb-ee15-4f31eab65afb