Claim total
$6,879.09
base $127.17 · payer covered $5,503.28
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-12-31
- Stop
- 2025-12-31
The parties
- Patient
- patient Long Lee Koelpin
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicare
Record id
3262d190-0790-ed5d-f843-64850daa8575