Claim total
$702.96
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1985-06-29
- Stop
- 1985-06-30
The parties
- Patient
- patient Huong Verla Wilderman
- Provider
- provider Odis Ortiz
- Payer
- payer No insurance
Record id
3457d972-15d5-e8c6-e3e8-cf335858242b