Claim total
$830.97
base $93.83 · payer covered $581.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-06-26
- Stop
- 2014-06-26
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
Record id
03563bad-3832-f030-47fb-37cfdf9c3a44