Claim total
$693.52
base $155.66 · payer covered $643.52
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-09-01
- Stop
- 2026-09-01
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-c250-93bc7ee10fc1