Claim total
$568.41
base $93.83 · payer covered $568.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-12-04
- Stop
- 2016-12-04
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Avery VonRueden
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-7577-df842f0249a4