Claim total
$693.52
base $155.66 · payer covered $554.81
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2015-08-06
- Stop
- 2015-08-06
The parties
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-72ad-8de93d5a9b67