Claim total
$435.48
base $93.83 · payer covered $335.48
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-12-05
- Stop
- 2024-12-05
The parties
- Patient
- patient Terese Darla Williamson
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
0098424c-ec2c-0924-d2dd-1c9f19919317