Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2004-05-23
- Stop
- 2004-05-23
The parties
- Patient
- patient Irving Noah Zboncak
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicare
Record id
2f7a09c8-cdf2-9b2d-103e-6a0fff961265