Claim total
$808.53
base $155.66 · payer covered $646.82
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-07-10
- Stop
- 2024-07-10
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-d2ee-47ebdc97c0ff