Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2003-10-08
- Stop
- 2003-10-08
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-e15d-422ab6797926