Claim total
$4,330.96
base $155.66 · payer covered $2,515.16
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2007-07-19
- Stop
- 2007-07-19
The parties
- Patient
- patient Aldo Abram Herzog
- Provider
- provider Odis Ortiz
- Payer
- payer Anthem
Record id
0c8e2690-e26c-68ee-4442-0a0430d67583