Claim total
$641.13
base $93.83 · payer covered $512.90
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-11-12
- Stop
- 2017-11-12
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
03e24eff-3793-eaeb-21dd-6ac79aba2b88