Claim total
$1,047.63
base $155.66 · payer covered $997.63
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2026-03-03
- Stop
- 2026-03-03
The parties
- Patient
- patient Benton Terrance Mills
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Medicaid
Record id
2549a80c-7eed-22f1-3e09-af9e81ac1cf5