Claim total
$9,327.69
base $155.66 · payer covered $9,292.69
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2014-04-25
- Stop
- 2014-04-25
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-8547-4a29-71bf-00faf11340cc