Claim total
$487.87
base $155.66 · payer covered $487.87
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1995-11-03
- Stop
- 1995-11-03
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
Record id
062f00f9-5db0-55c4-e1fd-2a75957eeae0