Claim total
$1,235.38
base $155.66 · payer covered $1,185.38
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-11-15
- Stop
- 2025-11-15
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-7ce7-7b0bda2ac762