Claim total
$772.61
base $155.66 · payer covered $618.09
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2017-02-07
- Stop
- 2017-02-07
The parties
- Patient
- patient Amalia Ana María Soliz
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Medicare
Record id
007eb971-e9c1-129f-42b5-c022fc39fcc4