Claim total
$835.89
base $155.66 · payer covered $835.89
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2015-04-19
- Stop
- 2015-04-19
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-8ead-712edd5db27e