Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2003-01-02
- Stop
- 2003-01-03
The parties
- Patient
- patient Truman Courtney Ferry
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
17e9a88b-30dd-4396-3b93-07bc7afb8bdb