Claim total
$1,062.21
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-07-21
- Stop
- 2025-07-21
The parties
- Patient
- patient Augustus Rich Stark
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
0239a00d-0894-874c-d3d1-0f64442e4b0f