Claim total
$3,034.76
base $155.66 · payer covered $3,034.76
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- diagnosis concept Diabetes mellitus type 244054006
- Start
- 2023-12-26
- Stop
- 2023-12-26
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Catalina Weimann
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Aetna
Record id
047ee4ec-c50b-b504-36f0-559c81b9f014