Claim total
$487.87
base $155.66 · payer covered $390.29
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2015-09-03
- Stop
- 2015-09-03
The parties
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-a611-aea5431a6d13