Claim total
$908.61
base $155.66 · payer covered $858.61
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2022-04-08
- Stop
- 2022-04-08
The parties
- Patient
- patient Lee Scot Rosenbaum
- Provider
- provider Odis Ortiz
- Payer
- payer Medicaid
Record id
027e2621-860b-6019-f744-6087a096c441