Claim total
$979.20
base $155.66 · payer covered $929.20
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-07-16
- Stop
- 2025-07-16
The parties
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-f259-04e9179b26b5