Claim total
$1,080.04
base $93.39 · payer covered $1,080.04
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2012-12-06
- Stop
- 2012-12-06
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-c7a9-8c95-1994235ce715