Claim total
$711.72
base $93.83 · payer covered $711.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-03-31
- Stop
- 2023-03-31
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-064a-0dec652ae134