Claim total
$1,104.25
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2011-04-03
- Stop
- 2011-04-03
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Tiffany Smitham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-7c8b-87f588f6d9f2