Claim total
$1,103.68
base $93.39 · payer covered $1,103.68
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2017-09-17
- Stop
- 2017-09-17
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-ef8d-4221ccd8f04e