Claim total
$767.69
base $93.83 · payer covered $617.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-11-04
- Stop
- 1988-11-04
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-8547-4a29-3c47-bcb8298b0b1f