Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1976-09-30
- Stop
- 1976-09-30
The parties
- Patient
- patient Freeman Winfred Erdman
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicare
Record id
17dd8403-c3e7-454f-07b0-f8656c26e852