Claim total
$1,167.79
base $93.39 · payer covered $1,167.79
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2010-09-12
- Stop
- 2010-09-12
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Alesia Douglas
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-7b7f-e249f2463f32