Claim total
$946.77
base $155.66 · payer covered $757.41
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-01-14
- Stop
- 2026-01-14
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-f356-ffe34a7f68ca