Claim total
$702.96
base $155.66 · payer covered $421.78
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2013-10-14
- Stop
- 2013-10-14
The parties
- Patient
- patient Augustus Rich Stark
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Humana
Record id
0239a00d-0894-874c-4a1f-5b8871e8bae5