Claim total
$978.26
base $155.66 · payer covered $943.26
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2019-05-15
- Stop
- 2019-05-15
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-c08e-1ba6e2d99891