Claim total
$1,168.10
base $155.66 · payer covered $934.47
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2012-09-17
- Stop
- 2012-09-17
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-3859-d131bfbb3d44