Claim total
$1,099.54
base $155.66 · payer covered $1,064.54
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-08-02
- Stop
- 2026-08-02
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-b8da-e052e40492d3