Claim total
$702.96
base $155.66 · payer covered $562.37
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2019-12-21
- Stop
- 2019-12-21
The parties
- Patient
- patient Jani Yolando Nitzsche
- Provider
- provider Rigoberto Dibbert
- Payer
- payer Medicare
Record id
04f07ca4-67b1-b65a-e2e4-e2077aa3f413