Claim total
$93.39
base $93.39 · payer covered $93.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-05-30
- Stop
- 2014-05-30
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-c7a9-627f-bfc9fd0ebd95