Claim total
$13,551.50
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1990-12-20
- Stop
- 1990-12-20
The parties
- Patient
- patient Donn Jason Stanton
- Provider
- provider Odis Ortiz
- Payer
- payer No insurance
Record id
1865a78e-26da-9b77-96b8-22a779149bd7