Claim total
$979.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-03-27
- Stop
- 2018-03-27
The parties
- Patient
- patient Edie Victoria Zulauf
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
2fbaa88f-9da9-5871-0066-4f4a69fde0c9