Claim total
$1,041.54
base $155.66 · payer covered $1,006.54
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2019-05-08
- Stop
- 2019-05-08
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Dual Eligible
Record id
03eafe4d-23cd-eb61-68cf-c5b508089a05