Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-08-02
- Stop
- 2013-08-02
The parties
- Patient
- patient Anjelica Phebe Murphy
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
103d8b63-825b-6621-a6b9-c690b7687195