Claim total
$1,078.75
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-09-17
- Stop
- 1987-09-17
The parties
- Patient
- patient Aldo Abram Herzog
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
0c8e2690-e26c-68ee-6a74-0d6f5fdbe141