Claim total
$875.67
base $155.66 · payer covered $825.67
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-08-04
- Stop
- 2026-08-04
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-b24a-aadf27479ddd