Claim total
$641.13
base $93.83 · payer covered $328.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-08-21
- Stop
- 2011-08-21
The parties
- Patient
- patient Nadine Jennette Blanda
- Provider
- provider Margene Stoltenberg
- Care site
- care site SOUTHDALE INTERNAL MEDICINE PA
- Payer
- payer Medicare
Record id
2fd4d5da-96ab-f21b-cdc8-076f47b63f4b