Claim total
$832.54
base $155.66 · payer covered $782.54
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2011-11-18
- Stop
- 2011-11-18
The parties
- Patient
- patient Ginger Jamie Feil
- Provider
- provider Rigoberto Dibbert
- Payer
- payer Medicaid
Record id
291eef3f-a432-2174-e891-dd1b47354000