Claim total
$566.96
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2010-02-27
- Stop
- 2010-02-28
The parties
- Patient
- patient Corrina Leontine Smith
- Provider
- provider Odis Ortiz
- Payer
- payer Humana
Record id
03b48c3f-9d97-2f75-8c06-1a182e147617