Claim total
$829.52
base $155.66 · payer covered $205.52
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2017-08-30
- Stop
- 2017-08-30
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
Record id
0291d14d-46f7-a76b-5a85-6fe20e6064a9