Claim total
$1,090.27
base $155.66 · payer covered $872.21
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-06-12
- Stop
- 2024-06-12
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-2599-3a4d151effba