Claim total
$836.83
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 1994-07-10
- Stop
- 1994-07-10
The parties
- Patient
- patient Fidel Russel
- Provider
- provider Rigoberto Dibbert
- Payer
- payer No insurance
Record id
2fefde94-f55b-b6a2-6576-37b484b1c76b