Claim total
$4,738.22
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2015-12-11
- Stop
- 2015-12-11
The parties
- Patient
- patient Norbert Mitch Rolfson
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Aetna
Record id
0e9a274f-7ba6-2bd1-8af1-4fba35ca5d40