Claim total
$907.94
base $155.66 · payer covered $857.94
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-04-06
- Stop
- 2024-04-06
The parties
- Patient
- patient Dorotea Yolanda Palomo
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
04ad2732-b952-4fbb-45dc-9a2357791b03