Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-17
- Stop
- 2021-04-17
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Silvana Weber
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
04f9baea-0c64-12b2-6ee6-ac928a9396b9