Claim total
$1,025.73
base $155.66 · payer covered $975.73
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-07-06
- Stop
- 2025-07-06
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-6834-8d9845c06493