Claim total
$773.55
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-04-08
- Stop
- 2026-04-08
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer No insurance
Record id
043d6e13-0cc7-07f3-79ca-dda29ae1e09b