Claim total
$505.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1982-12-13
- Stop
- 1982-12-13
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-c022-6dc7a3f058f4