Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1998-10-08
- Stop
- 1998-10-08
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-a11c-2d90c48d2a7e