Claim total
$1,373.75
base $155.66 · payer covered $1,098.99
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2012-09-03
- Stop
- 2012-09-03
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-9242-00369dfba2b8