Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2008-10-29
- Stop
- 2008-10-29
The parties
- Patient
- patient Mallory Bobette Stehr
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
0ebd7f5a-eab8-697e-2497-17c4a0144446