Claim total
$905.26
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1974-02-11
- Stop
- 1974-02-11
The parties
- Patient
- patient Wanda Sharee Treutel
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer No insurance
Record id
07596fa0-6882-bc3c-4881-62b19a6e6811