Claim total
$693.52
base $155.66 · payer covered $554.81
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-06-17
- Stop
- 2026-06-17
The parties
- Patient
- patient Lorilee Rau
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
01b2da20-8b0d-5eee-ea84-bfeca73aaecd