Claim total
$1,297.09
base $155.66 · payer covered $778.26
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2016-02-14
- Stop
- 2016-02-14
The parties
- Patient
- patient Leo Ramon Wolf
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Aetna
Record id
0132d8d5-6e6e-d90f-fb3a-c1a19a267c7a