Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2019-10-22
- Stop
- 2019-10-22
The parties
- Patient
- patient Terese Darla Williamson
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
0098424c-ec2c-0924-0165-34d42d50671f