Claim total
$978.26
base $155.66 · payer covered $586.96
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 1984-05-06
- Stop
- 1984-05-06
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-638e-edb1fd2e29a5