Claim total
$772.61
base $155.66 · payer covered $618.09
The visit
- Class
- Urgent care
- Code
- 702927004
- Reason
- —
- Start
- 2019-01-02
- Stop
- 2019-01-02
The parties
- Patient
- patient Louie Petrina Ziemann
- Provider
- provider Rigoberto Dibbert
- Payer
- payer Medicare
Record id
2db8ed08-2422-5c8b-2eb1-d738b05c226c