Claim total
$1,159.71
base $93.83 · payer covered $927.76
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-06-09
- Stop
- 2024-06-09
The parties
- Patient
- patient Penny Shona Schaden
- Provider
- provider Celsa Bailey
- Care site
- care site INDEPENDENT MEDICAL CLINIC PA
- Payer
- payer Medicare
Record id
03e70281-0fa0-c7c6-cbf6-6a15ad2e4573