Claim total
$127.17
base $127.17 · payer covered $54.34
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2025-01-30
- Stop
- 2025-01-30
The parties
- Patient
- patient Caroyln Aura O'Keefe
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
1b6bd1af-c430-b2c8-be22-bb792d396ab8