Claim total
$3,962.57
base $155.66 · payer covered $3,812.57
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1963-04-23
- Stop
- 1963-04-23
The parties
- Patient
- patient Laverne Neal Brakus
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
18f6d2aa-fdf5-2347-75bf-4e5b0ffed2ab