Claim total
$1,551.82
base $155.66 · payer covered $1,241.45
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2014-01-05
- Stop
- 2014-01-05
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicare
Record id
058279b6-7701-4823-d2b9-bd8df2590212