Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-10-04
- Stop
- 2006-10-04
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
043d6e13-0cc7-07f3-e948-a905dd447739