Claim total
$1,025.73
base $155.66 · payer covered $1,025.73
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1994-09-02
- Stop
- 1994-09-02
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
Record id
062f00f9-5db0-55c4-8329-dde485f055aa