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

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About Me
Caribou, ME
Location
35.1
BMI
RNY
Surgery
06/16/2008
Surgery Date
May 23, 2004
Member Since

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