Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Essential hypertension59621000
- Start
- 2023-08-29
- Stop
- 2023-08-29
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Chance Wisoky
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
04f9baea-0c64-12b2-0405-3cd7718bac26