Claim total
$1,516.12
base $155.66 · payer covered $1,212.89
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2019-06-19
- Stop
- 2019-06-19
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Odis Ortiz
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-2c78-d2f6c925d051