Claim total
$1,469.38
base $155.66 · payer covered $1,419.38
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2023-07-30
- Stop
- 2023-07-30
The parties
- Patient
- patient Jon Lavern Baumbach
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
033f4a7e-c2bc-1f12-03e3-1b7074a62be4