Claim total
$756.80
base $155.66 · payer covered $721.80
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2021-07-28
- Stop
- 2021-07-28
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Dual Eligible
Record id
0324eea5-bb16-c29a-8475-68da29a125fe