Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2025-06-05
- Stop
- 2025-06-05
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-e1b9-004a56d3d589