Claim total
$756.80
base $155.66 · payer covered $605.43
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-05-15
- Stop
- 2024-05-15
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Odis Ortiz
- Payer
- payer Anthem
Record id
0190d3b1-c50c-bf7b-109b-d39069d29b9a