Claim total
$700.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-10-15
- Stop
- 1992-10-15
The parties
- Patient
- patient Aldo Abram Herzog
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
0c8e2690-e26c-68ee-ee47-bdf4cb3f8ff9