Claim total
$702.96
base $155.66 · payer covered $667.96
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2022-08-14
- Stop
- 2022-08-14
The parties
- Provider
- provider Rigoberto Dibbert
- Payer
- payer Dual Eligible
Record id
014b9cfb-a71a-d032-a55c-3512881b58a3