Claim total
$630.24
base $155.66 · payer covered $630.24
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2016-11-20
- Stop
- 2016-11-20
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-ba28-a3b72f2cede2