Claim total
$829.52
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1995-05-24
- Stop
- 1995-05-24
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
- Payer
- payer No insurance
Record id
0291d14d-46f7-a76b-01f9-8d8898fb7e5c