Claim total
$908.61
base $155.66 · payer covered $758.61
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1977-09-17
- Stop
- 1977-09-17
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-25fe-8c132c3dc92d