Claim total
$3,973.46
base $93.83 · payer covered $3,178.76
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-07-28
- Stop
- 2018-07-28
The parties
- Patient
- patient Sharie Nikia Hegmann
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
00decd7e-554a-447f-bb4d-8557711fb061