Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1990-06-17
- Stop
- 1990-06-17
The parties
- Patient
- patient Gus Clair Nitzsche
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
105ade21-1b58-baca-0c00-e06a387d8fd8