Claim total
$640.95
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1999-06-11
- Stop
- 1999-06-11
The parties
- Patient
- patient Anjelica Phebe Murphy
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
103d8b63-825b-6621-261f-de36b30146a3