Claim total
$908.61
base $155.66 · payer covered $908.61
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2008-12-05
- Stop
- 2008-12-05
The parties
- Patient
- patient Alvin Raymond Wilderman
- Provider
- provider Odis Ortiz
- Payer
- payer UnitedHealthcare
Record id
2d01a944-5d28-8528-fc67-3dc160821436