Claim total
$4,309.08
base $155.66 · payer covered $4,274.08
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2013-11-01
- Stop
- 2013-11-01
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Dual Eligible
Record id
00eec58c-8547-4a29-18eb-831619e1f2e4