Claim total
$1,048.85
base $155.66 · payer covered $839.08
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2015-01-19
- Stop
- 2015-01-20
The parties
- Patient
- patient Garland Thiel
- Provider
- provider Rigoberto Dibbert
- Payer
- payer Medicare
Record id
02ec371b-21cc-5c35-41db-b6de932b3893