Claim total
$1,754.82
base $93.39 · payer covered $1,052.89
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2011-08-24
- Stop
- 2011-08-24
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-d242-c101b42f277e