Claim total
$1,327.18
base $93.39 · payer covered $1,327.18
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-01-11
- Stop
- 2015-01-11
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Trinidad Quitzon
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-f605-c050456b8ab8