Claim total
$637.55
base $155.66 · payer covered $587.55
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2016-08-19
- Stop
- 2016-08-19
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-3203-08ab75d6702c