Claim total
$843.20
base $155.66 · payer covered $674.56
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2020-02-25
- Stop
- 2020-02-25
The parties
- Patient
- patient Domenic Brock Dach
- Provider
- provider Rigoberto Dibbert
- Payer
- payer Medicare
Record id
19137cbd-9649-bf65-23c4-072195d4245b