Claim total
$4,087.31
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1980-03-09
- Stop
- 1980-03-09
The parties
- Patient
- patient Pete Roberto Streich
- Provider
- provider Odis Ortiz
- Payer
- payer No insurance
Record id
29a638b7-ee8f-0f2e-c7b6-002d1ead5790