Claim total
$1,218.64
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1993-06-05
- Stop
- 1993-06-05
The parties
- Patient
- patient Deandre Dylan Wisozk
- Provider
- provider Odis Ortiz
- Payer
- payer No insurance
Record id
198037c0-3402-fbe3-226a-91686393ad69