Claim total
$4,105.88
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2025-09-20
- Stop
- 2025-09-20
The parties
- Patient
- patient Marylou Abernathy
- Provider
- provider Thao Terry
- Care site
- care site URGENT AMERIKAN CLINIC
- Payer
- payer Humana
Record id
364c439b-3ca4-d8e6-dffe-72a2829ae7a2