Claim total
$767.69
base $93.83 · payer covered $9.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-07-25
- Stop
- 2019-07-25
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
Record id
03563bad-3832-f030-94e0-cf52c4c5f6e3