Claim total
$979.20
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-05-15
- Stop
- 2024-05-15
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer No insurance
Record id
043d6e13-0cc7-07f3-9a6e-03f4bb8b8c4a