Claim total
$93.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-05-09
- Stop
- 2019-05-09
The parties
- Patient
- patient Terese Darla Williamson
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
0098424c-ec2c-0924-e2e9-c1ec7cd1faa5