Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2022-12-09
- Stop
- 2022-12-09
The parties
- Patient
- patient Dina Lolita Schaefer
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicare
Record id
13377e52-60c9-b8ee-9273-c9e6b73d1eb4