Claim total
$1,115.43
base $93.83 · payer covered $705.93
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-05-24
- Stop
- 2002-05-24
The parties
- Patient
- patient Joaquín Benjamín Rivero
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
2d546f3c-e25a-6984-2ffb-dcd11f04c7e2