Claim total
$978.26
base $155.66 · payer covered $782.61
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2019-10-06
- Stop
- 2019-10-06
The parties
- Patient
- patient Tawanna Nedra Kuhlman
- Provider
- provider Odis Ortiz
- Payer
- payer UnitedHealthcare
Record id
00508659-1210-a7fa-2395-fe9fa4db6c34