Claim total
$566.96
base $155.66 · payer covered $453.57
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2017-09-07
- Stop
- 2017-09-07
The parties
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-c180-d58bfdc4d727