Claim total
$1,141.95
base $155.66 · payer covered $799.37
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2019-01-05
- Stop
- 2019-01-05
The parties
- Patient
- patient Leslee Christiansen
- Provider
- provider Odis Ortiz
- Payer
- payer Cigna Health
Record id
01280686-ae2e-42f0-f1e6-1ae80bab5473