Claim total
$829.52
base $155.66 · payer covered $465.96
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2012-08-22
- Stop
- 2012-08-22
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
Record id
0291d14d-46f7-a76b-b2f6-9956d683e38a