Claim total
$630.24
base $155.66 · payer covered $504.19
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2003-11-19
- Stop
- 2003-11-19
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-7aba-da85fbc7b736