Claim total
$4,553.36
base $155.66 · payer covered $4,403.36
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2002-02-09
- Stop
- 2002-02-09
The parties
- Patient
- patient Edwardo Baumbach
- Provider
- provider Rigoberto Dibbert
- Payer
- payer Medicaid
Record id
10e41b04-0f54-fb52-a0ce-8235394ee65f