Claim total
$702.96
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2013-04-29
- Stop
- 2013-04-29
The parties
- Patient
- patient Adam Jones
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Aetna
Record id
00229130-e769-8779-9958-08654f9010ba