Claim total
$711.28
base $93.39 · payer covered $676.28
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2017-05-29
- Stop
- 2017-05-29
The parties
- Provider
- provider Michael Dibbert
- Payer
- payer Dual Eligible
Record id
04481159-34f8-6925-df9e-e58f8d0123e6