Claim total
$497.31
base $155.66 · payer covered $447.31
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2006-11-10
- Stop
- 2006-11-10
The parties
- Patient
- patient Pedro Vicente Toledo
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
3aa09201-a05b-e3eb-2035-9d5c16b9c2f3