Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2021-10-12
- Stop
- 2021-10-12
The parties
- Patient
- patient Queen Sharika Fay
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
02c148c0-182c-a5fd-ab15-5f5af0fe35fd