Claim total
$1,185.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-12-22
- Stop
- 1986-12-22
The parties
- Patient
- patient Bo Gino Murazik
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
003af57f-1886-144b-77f2-139378d635c2