Claim total
$915.99
base $93.39 · payer covered $915.99
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2016-12-11
- Stop
- 2016-12-11
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Letisha Graham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-99af-b3559264c4b5