Claim total
$1,123.04
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1964-01-07
- Stop
- 1964-01-07
The parties
- Patient
- patient Jacqulyn Lavonna Legros
- Provider
- provider Clarita Johnston
- Care site
- care site GARGAR URGENT CARE AND CLINIC
- Payer
- payer Humana
Record id
28e07049-ca1f-fcfe-58aa-9fa6c28964a5