Claim total
$919.02
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2006-02-22
- Stop
- 2006-02-22
The parties
- Patient
- patient Carlyn Donita Ortiz
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
00e3929f-91f8-0715-243a-89060c751a62