Claim total
$4,305.24
base $155.66 · payer covered $4,270.24
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2014-01-03
- Stop
- 2014-01-03
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Dual Eligible
Record id
00eec58c-8547-4a29-dd44-7708e1a63d83