Claim total
$773.55
base $155.66 · payer covered $723.55
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2019-02-15
- Stop
- 2019-02-15
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-b9fe-184808b091f3