Claim total
$93.40
base $93.39 · payer covered $74.72
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-04-26
- Stop
- 2025-04-26
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Chance Wisoky
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
04f9baea-0c64-12b2-77e7-0ad947f943c6