Claim total
$1,142.45
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-11-07
- Stop
- 1983-11-07
The parties
- Patient
- patient Carolee Lorette Nienow
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
162c02fb-cffd-80fd-81cb-33ee965918e0