Claim total
$1,109.34
base $93.83 · payer covered $887.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-12-21
- Stop
- 2016-12-21
The parties
- Patient
- patient Lorilee Rau
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
01b2da20-8b0d-5eee-8222-4ea7b037bddc