Claim total
$973.34
base $93.83 · payer covered $973.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-02-27
- Stop
- 2009-02-27
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Fredrick Strosin
- Care site
- care site OPTAGE PRIMARY CARE LLC
- Payer
- payer Dual Eligible
Record id
00eec58c-8547-4a29-303b-2e4708543d18