Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-11-17
- Stop
- 2019-11-17
The parties
- Patient
- patient Josefina Mojica
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
06d3e002-d020-7c66-371a-7ce694167b50