Claim total
$1,579.40
base $155.66 · payer covered $1,263.51
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-09-10
- Stop
- 2025-09-10
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Odis Ortiz
- Payer
- payer Anthem
Record id
0190d3b1-c50c-bf7b-1cff-68f4d1fa10b4