Caribou ME
Medical Costs Associated With My Surgery
| Service | Procedure | Provider | Total | Amount | Member |
| Date(s) | Name | Billed | Paid | Responsibility | |
| 12/16/2008 - 12/16/2008 | 6 - Month Follow-Up | TODER | $172.00 | $48.56 | $30.00 |
| 12/16/2008 - 12/16/2008 | 6 - Month Dietition | EASTERN MAINE M | $82.00 | $79.65 | $0.00 |
| 12/04/2008 - 12/04/2008 | 6 - Month Labs | CARY MEDICAL CE | $416.00 | $401.44 | $0.00 |
| 09/08/2008 - 09/08/2008 | 3 - Month Group Dietition | EASTERN MAINE M | $116.00 | $112.67 | $0.00 |
| 07/29/2008 - 07/29/2008 | 6-Week Dietition | EASTERN MAINE M | $76.00 | $73.75 | $0.00 |
| 07/01/2008 - 07/01/2008 | 2-Week Follow-Up | HUANG | N/C | $0.00 | $0.00 |
| 07/01/2008 - 07/01/2008 | Dietitian | EASTERN MAINE M | $76.00 | $73.75 | $0.00 |
| 06/16/2008 - 06/18/2008 | Surgery | EASTERN MAINE M | $31,352.70 | $23,057.11 | $7,430.26 |
| 06/04/2008 - 06/04/2008 | Blood Tests/EKG | CARY MEDICAL CE | $443.00 | $0.00 | $427.50 |
| 03/27/2008 - 03/27/2008 | Surgeon Consult | HUANG | $225.00 | $100.00 | $30.00 |
| 03/27/2008 - 03/27/2008 | Blood Tests | EASTERN MAINE M | $298.00 | $0.00 | $289.17 |
| 02/29/2008 - 02/29/2008 | Follow-Up With Primary Per Psychologist | GAHAGAN | $111.00 | $81.00 | $30.00 |
| 02/21/2008 - 02/21/2008 | Psychologist | ACADIA HOSPITAL | $856.00 | $0.00 | $830.66 |
| 02/11/2008 - 02/11/2008 | Blood Tests / Potassium Check | BURCHILL | $15.00 | $0.00 | $2.96 |
| 02/11/2008 - 02/11/2008 | Dietitian | EASTERN MAINE M | $112.00 | $0.00 | $108.68 |
| 12/26/2007 - 12/26/2007 | Nutrition Class / Physical Therapist | EASTERN MAINE M | $270.00 | $0.00 | $262.01 |
| 11/14/2007 - 11/14/2007 | Blood tests | CARY MEDICAL CE | $400.00 | $0.00 | $386.00 |
| 11/13/2007 - 11/13/2007 | Initial Consult With Physician | BURCHILL | $70.00 | $40.00 | $30.00 |
| Total | $35,090.70 | $9,857.24 |
About Me
Caribou, ME
Location
35.1
BMI
Surgery
06/16/2008
Surgery Date
May 23, 2004
Member Since
