Claim total
$1,112.41
base $93.83 · payer covered $703.52
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-11-01
- Stop
- 2023-11-01
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
046c8377-6cc1-c8f9-2541-be0976134b3e