Claim total
$1,035.17
base $155.66 · payer covered $828.13
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2018-08-22
- Stop
- 2018-08-22
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-0086-205581e8c8e5