Claim total
$908.61
base $155.66 · payer covered $726.89
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1997-01-18
- Stop
- 1997-01-18
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-ea84-1f188702a567