Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2021-06-12
- Stop
- 2021-06-12
The parties
- Patient
- patient Tyrone Gerry Nolan
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
0372df5d-1b51-df61-f082-9fe0c1bbb4f5