Claim total
$918.15
base $93.83 · payer covered $551.23
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-10-08
- Stop
- 2003-10-08
The parties
- Patient
- patient Lorilee Rau
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
01b2da20-8b0d-5eee-8089-9dc9962a719d