Claim total
$127.17
base $127.17 · payer covered $76.30
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2024-08-13
- Stop
- 2024-08-13
The parties
- Patient
- patient Edie Victoria Zulauf
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Humana
Record id
2fbaa88f-9da9-5871-7da5-a1dd3b909fad