Claim total
$970.67
base $155.66 · payer covered $920.67
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2007-12-02
- Stop
- 2007-12-02
The parties
- Patient
- patient Robt Hahn
- Provider
- provider Odis Ortiz
- Payer
- payer Medicaid
Record id
14b4237b-95dd-cd17-207a-bb275b6b38a2