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
- 2022-11-15
- Stop
- 2022-11-15
The parties
- Patient
- patient Larita Candi Bashirian
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Cigna Health
Record id
1a69b1c3-11f2-231e-2e7e-61acd7dbccb5