Claim total
$1,597.60
base $93.83 · payer covered $958.57
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-04-29
- Stop
- 1984-04-29
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-9d31-a6a55635b495