Claim total
$1,210.15
base $155.66 · payer covered $1,175.15
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-02-01
- Stop
- 2026-02-01
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Dual Eligible
Record id
03478e49-59cf-7140-7961-e77ec12f209a