Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-09-29
- Stop
- 2020-09-29
The parties
- Patient
- patient Augustus Rich Stark
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Humana
Record id
0239a00d-0894-874c-b9aa-457a10efadff