Claim total
$787.46
base $93.83 · payer covered $737.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-03-01
- Stop
- 1994-03-01
The parties
- Patient
- patient Sylvie Viviana Feest
- Provider
- provider Fredrick Strosin
- Care site
- care site OPTAGE PRIMARY CARE LLC
- Payer
- payer Medicaid
Record id
3206c5ca-dc89-df44-8a1f-69de652600d9