Claim total
$838.96
base $155.66 · payer covered $688.96
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1986-04-11
- Stop
- 1986-04-11
The parties
- Patient
- patient Scott Emelina Fisher
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Medicaid
Record id
3876b3a4-351a-6d35-e2ec-c6ddb7029ecc