Claim total
$836.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-06-18
- Stop
- 1996-06-18
The parties
- Patient
- patient Catharine Many Nolan
- Provider
- provider Todd Marks
- Care site
- care site INDEPENDENT MEDICAL CLINIC PA
- Payer
- payer No insurance
Record id
03cbffbc-74a2-befb-5cfd-9ebf6281a0a4