Claim total
$1,525.56
base $155.66 · payer covered $1,490.56
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1974-04-12
- Stop
- 1974-04-12
The parties
- Patient
- patient Judy Yundt
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Dual Eligible
Record id
28694091-a035-e362-8fc3-5e75608551e5