Claim total
$1,289.11
base $155.66 · payer covered $1,031.28
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-07-17
- Stop
- 2024-07-17
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Odis Ortiz
- Payer
- payer Anthem
Record id
0190d3b1-c50c-bf7b-ad35-01725840ec52