Claim total
$702.96
base $155.66 · payer covered $652.96
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2014-09-17
- Stop
- 2014-09-17
The parties
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
010d736c-d81f-3cd7-7c66-1a4ec8034fe4