Claim total
$1,226.24
base $93.83 · payer covered $980.98
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-02-16
- Stop
- 2007-02-16
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Eduardo Rubio
- Care site
- care site OPTAGE PRIMARY CARE LLC
- Payer
- payer Medicare
Record id
00eec58c-8547-4a29-d269-39d7c21b4d11