Claim total
$1,036.18
base $93.39 · payer covered $621.71
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2009-09-06
- Stop
- 2009-09-06
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-d39d-fa69688726b6