Claim total
$1,463.73
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1962-03-30
- Stop
- 1962-03-30
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
Record id
062f00f9-5db0-55c4-86e5-c2fdcffa21bc