Claim total
$773.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2015-09-10
- Stop
- 2015-09-10
The parties
- Patient
- patient Latesha Heaney
- Provider
- provider Eduardo Rubio
- Care site
- care site OPTAGE PRIMARY CARE LLC
- Payer
- payer Humana
Record id
02ab4e74-e091-f51b-dfcf-c574a8d3f3b9