Claim total
$702.96
base $155.66 · payer covered $702.96
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2007-08-11
- Stop
- 2007-08-11
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Humana
Record id
01bbe7d1-151b-3eec-8767-05dc1278cf86