Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-02-20
- Stop
- 2022-02-20
The parties
- Patient
- patient Erwin Fredric Gibson
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
259579f5-e088-c375-2fd2-73c17dce4e2d