Claim total
$1,430.10
base $93.39 · payer covered $1,430.10
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-09-16
- Stop
- 2012-09-16
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Madalyn Konopelski
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-bcd5-b117f52b8ee2