Claim total
$2,623.46
base $155.66 · payer covered $2,098.77
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2026-01-30
- Stop
- 2026-01-30
The parties
- Provider
- provider Li Ebert
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
018a1080-c6e3-9b93-807f-f865db1e8ad7