Claim total
$97.23
base $93.39 · payer covered $77.78
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2026-05-09
- Stop
- 2026-05-09
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-f78f-0960ff2e3110