Claim total
$155.66
base $155.66 · payer covered $63.14
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2020-05-16
- Stop
- 2020-05-16
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-02f5-7b83cafb6233