Claim total
$1,168.10
base $155.66 · payer covered $1,168.10
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept History of renal transplant161665007
- Start
- 2017-08-20
- Stop
- 2017-08-20
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-1592-fd16bb57a236