Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1966-08-23
- Stop
- 1966-08-23
The parties
- Patient
- patient Collin Vance Hoeger
- Provider
- provider Todd Marks
- Care site
- care site INDEPENDENT MEDICAL CLINIC PA
Record id
3ab2fb2c-4f8f-5401-6c66-8197b9bc34d7