Claim total
$1,495.98
base $155.66 · payer covered $607.20
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-06-14
- Stop
- 2025-06-14
The parties
- Patient
- patient Reatha Victor O'Conner
- Provider
- provider Odis Ortiz
- Payer
- payer Aetna
Record id
0521a0be-ba7b-b4e6-ea75-5ef9047b26a0