Claim total
$843.20
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2024-04-29
- Stop
- 2024-04-29
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Rigoberto Dibbert
Record id
01bd7d75-9405-280a-8d7a-615bf50fb42d