Claim total
$1,110.08
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2015-02-28
- Stop
- 2015-02-28
The parties
- Patient
- patient Santo Quentin Mueller
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer No insurance
Record id
01845754-7d83-d7eb-1b2e-3b92b324c7f2