Claim total
$282.22
base $155.66 · payer covered $225.77
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2018-07-04
- Stop
- 2018-07-04
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-468f-e7ada632fe26