Claim total
$1,527.01
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-10-18
- Stop
- 1984-10-18
The parties
- Patient
- patient Aurelia Maude Goldner
- Provider
- provider Albert Blanda
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
1ce15169-0046-e0e5-5130-4cbdf274315a