Claim total
$841.98
base $155.66 · payer covered $23.21
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1986-05-20
- Stop
- 1986-05-20
The parties
- Patient
- patient Pete Ignacio Feest
- Provider
- provider Rigoberto Dibbert
- Payer
- payer UnitedHealthcare
Record id
09b9c891-0bef-2077-e5ec-ebcfb4a9493b