Claim total
$692.43
base $155.66 · payer covered $642.43
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2021-11-27
- Stop
- 2021-11-27
The parties
- Patient
- patient Gerardo Marvin Johns
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Medicaid
Record id
01513b97-46a6-1303-b280-d836572d4332