Claim total
$1,799.01
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-10-25
- Stop
- 1998-10-25
The parties
- Provider
- provider Celsa Bailey
- Care site
- care site INDEPENDENT MEDICAL CLINIC PA
- Payer
- payer No insurance
Record id
0c72ef78-e35b-9260-1d56-8608a498a015