Claim total
$1,049.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-05-05
- Stop
- 2007-05-05
The parties
- Patient
- patient Viki Nicki Pfannerstill
- Provider
- provider Celsa Bailey
- Care site
- care site INDEPENDENT MEDICAL CLINIC PA
Record id
378f5f5f-1bcf-284d-3ba6-e127daa2b930