Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2019-08-30
- Stop
- 2019-08-30
The parties
- Patient
- patient Lessie Mirta Altenwerth
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
Record id
19ded928-9aa0-52b6-a6fd-7f9fe38ad64c