Claim total
$1,225.05
base $155.66 · payer covered $0.00
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2012-10-09
- Stop
- 2012-10-09
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Rigoberto Dibbert
- Payer
- payer No insurance
Record id
02aef5a1-9ba3-229b-0664-ca1654500ab9