Claim total
$886.52
base $93.39 · payer covered $709.21
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Anemia271737000
- Start
- 2026-04-25
- Stop
- 2026-04-25
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
04f9baea-0c64-12b2-d77f-220a83d755b3