Claim total
$1,171.17
base $155.66 · payer covered $1,121.17
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-07-28
- Stop
- 2026-07-28
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-f2ff-45e44ece3dc5