Claim total
$962.45
base $155.66 · payer covered $927.45
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2020-07-08
- Stop
- 2020-07-09
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Odis Ortiz
- Payer
- payer Dual Eligible
Record id
03ef4f74-940b-d219-860f-044260a8f07d