Claim total
$758.25
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-04-01
- Stop
- 1999-04-01
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
Record id
03563bad-3832-f030-7bf5-fe147e2dee77