Claim total
$1,102.14
base $155.66 · payer covered $1,067.14
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-04-01
- Stop
- 2026-04-01
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-f3a0-ca5e6f6e5c30