Claim total
$162.97
base $155.66 · payer covered $127.97
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2023-04-05
- Stop
- 2023-04-05
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-54b3-06d8b8d18006