Claim total
$973.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-11-06
- Stop
- 2017-11-06
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-de7f-e1792a3cf17f