Claim total
$631.94
base $155.66 · payer covered $505.55
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2012-10-29
- Stop
- 2012-10-29
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-1ce9-03094685c028