Claim total
$526.59
base $155.66 · payer covered $368.62
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1995-07-28
- Stop
- 1995-07-28
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
Record id
062f00f9-5db0-55c4-9d37-6d5fe6651c99