Claim total
$968.54
base $155.66 · payer covered $818.54
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2023-03-26
- Stop
- 2023-03-26
The parties
- Patient
- patient Kent Ethan Yundt
- Provider
- provider Odis Ortiz
- Payer
- payer Medicaid
Record id
27b3914f-dfc0-a4bc-b1dd-95580544a942