Claim total
$1,246.39
base $155.66 · payer covered $997.11
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2021-12-04
- Stop
- 2021-12-04
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-2ebc-f53c59bb60e9