Claim total
$693.52
base $155.66 · payer covered $693.52
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2000-09-08
- Stop
- 2000-09-08
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
Record id
062f00f9-5db0-55c4-0e84-b961ff35d931