Claim total
$1,036.11
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2011-03-15
- Stop
- 2011-03-16
The parties
- Patient
- patient Caitlyn Elli Kuhlman
- Provider
- provider Odis Ortiz
- Payer
- payer No insurance
Record id
0037332a-29d1-a298-7a7e-7f7300a5a6c1