Claim total
$905.26
base $155.66 · payer covered $855.26
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1971-01-11
- Stop
- 1971-01-11
The parties
- Patient
- patient Geralyn Berniece Kirlin
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
18ec76c4-019a-43be-5006-13e0609d35b6