Claim total
$1,276.63
base $155.66 · payer covered $1,226.63
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-10-05
- Stop
- 2025-10-05
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-739a-97330dfb4473