Claim total
$766.24
base $155.66 · payer covered $716.24
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1999-08-24
- Stop
- 1999-08-24
The parties
- Patient
- patient Catharine Many Nolan
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
03cbffbc-74a2-befb-8240-63bf5c1baa2d