Claim total
$1,000.33
base $155.66 · payer covered $800.27
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2003-08-11
- Stop
- 2003-08-11
The parties
- Patient
- patient Albert Gaylord Kiehn
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicare
Record id
03865fba-8cf7-44f6-7b1d-fbd47c27fd27