Claim total
$766.24
base $155.66 · payer covered $612.99
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-10-19
- Stop
- 2024-10-19
The parties
- Patient
- patient Leslee Christiansen
- Provider
- provider Odis Ortiz
- Payer
- payer Anthem
Record id
01280686-ae2e-42f0-13b4-2d20640294e9