Claim total
$947.27
base $93.39 · payer covered $947.27
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept End-stage renal disease46177005
- Start
- 2015-11-05
- Stop
- 2015-11-05
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-0fda-46c970ede404