Claim total
$4,189.54
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Seizure disorder128613002
- Start
- 1989-09-03
- Stop
- 1989-09-03
The parties
- Patient
- patient Raye Suzy Gusikowski
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Humana
Record id
02c06e54-48b8-2b73-27fa-f4f437267e1a