Claim total
$767.69
base $93.83 · payer covered $614.14
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-09-03
- Stop
- 2026-09-03
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-e799-5c39cc575375