Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2023-04-13
- Stop
- 2023-04-13
The parties
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
04dc5210-87cc-ee45-4950-c2ffa20fcb29