Claim total
$504.69
base $93.39 · payer covered $217.35
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Sleep disorder39898005
- Start
- 2021-01-19
- Stop
- 2021-01-19
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
04f9baea-0c64-12b2-ce0a-3928556c7629