Claim total
$13,856.14
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1989-11-20
- Stop
- 1989-11-20
The parties
- Patient
- patient Kelly Carson Gutkowski
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer No insurance
Record id
177a983f-792c-a950-1669-9dce62ddf711