Claim total
$1,105.76
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1988-05-20
- Stop
- 1988-05-20
The parties
- Patient
- patient Corrina Joyce Shanahan
- Provider
- provider Rigoberto Dibbert
- Payer
- payer No insurance
Record id
21b692df-92b8-fcf1-c6c2-522fc9380cec