Claim total
$4,382.27
base $155.66 · payer covered $3,505.82
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-11-29
- Stop
- 2024-11-29
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-0979-6ed6abf70f82