Claim total
$1,412.05
base $93.83 · payer covered $1,412.05
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-03-05
- Stop
- 2010-03-05
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Fredrick Strosin
- Care site
- care site OPTAGE PRIMARY CARE LLC
- Payer
- payer Medicaid
Record id
00eec58c-8547-4a29-2ad7-5e3178f6034b