Claim total
$1,046.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-06-12
- Stop
- 1990-06-12
The parties
- Patient
- patient Catharine Many Nolan
- Provider
- provider Celsa Bailey
- Care site
- care site INDEPENDENT MEDICAL CLINIC PA
- Payer
- payer No insurance
Record id
03cbffbc-74a2-befb-a114-93d3be444d84