Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2018-08-26
- Stop
- 2018-08-26
The parties
- Patient
- patient Louella Roberts
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
05092f50-4c35-2d72-f7e5-cc4d67049e44