Claim total
$696.01
base $93.39 · payer covered $696.01
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept End-stage renal disease46177005
- Start
- 2017-01-21
- Stop
- 2017-01-21
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-c7a9-2510-8c61735317f9