Claim total
$1,309.94
base $155.66 · payer covered $1,259.94
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-12-14
- Stop
- 2025-12-14
The parties
- Patient
- patient Keith Marquis Ritchie
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Medicaid
Record id
30a39716-1c18-1f3a-a2b5-a7285cb528f2