Claim total
$694.53
base $93.39 · payer covered $694.53
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-12-23
- Stop
- 2012-12-23
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Jonas Pouros
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-f711-9d2df3b5cd5a