Claim total
$838.96
base $155.66 · payer covered $688.96
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1986-07-14
- Stop
- 1986-07-14
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Odis Ortiz
- Payer
- payer Medicaid
Record id
016a1a5e-4450-7aaa-caac-a6a47c38a5aa