Claim total
$3,899.29
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1978-11-08
- Stop
- 1978-11-08
The parties
- Patient
- patient Jimmie Micah Predovic
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer No insurance
Record id
2c84ecc3-1d6b-8ca5-7ae7-6a49df306a94