Claim total
$949.77
base $127.17 · payer covered $914.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2012-12-03
- Stop
- 2012-12-03
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Dual Eligible
Record id
03e24eff-3793-eaeb-def2-f250216cf9df