Claim total
$847.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-08-09
- Stop
- 1992-08-09
The parties
- Patient
- patient Sueann Zemlak
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
Record id
17e8982e-72b3-b77d-9ba1-8bfd8241ce64