Claim total
$1,513.00
base $155.66 · payer covered $1,463.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2015-09-09
- Stop
- 2015-09-09
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-1c40-838402631df3