Claim total
$379.16
base $155.66 · payer covered $303.33
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2018-08-16
- Stop
- 2018-08-16
The parties
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-0213-2115530c3c0c