Claim total
$7,652.50
base $155.66 · payer covered $7,617.50
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1991-07-09
- Stop
- 1991-07-09
The parties
- Provider
- provider Odis Ortiz
- Payer
- payer Dual Eligible
Record id
0126321a-a5af-784d-58a5-0bb949ff90d5