Claim total
$773.55
base $155.66 · payer covered $723.55
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2022-08-20
- Stop
- 2022-08-20
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-ceee-214596c59bf9