Claim total
$987.76
base $155.66 · payer covered $790.20
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-06-11
- Stop
- 2025-06-11
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Odis Ortiz
- Payer
- payer Anthem
Record id
0190d3b1-c50c-bf7b-5e3b-6fac8026ff00