Claim total
$704.41
base $93.83 · payer covered $563.52
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-08-28
- Stop
- 2025-08-28
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
03563bad-3832-f030-55b5-3e5ba000cd6a