Claim total
$572.79
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1958-12-14
- Stop
- 1958-12-14
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer No insurance
Record id
058279b6-7701-4823-40ca-fe93f14783d9