Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2009-07-20
- Stop
- 2009-07-20
The parties
- Patient
- patient Randell Irvin Gutmann
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
08da25e3-3ae1-e835-3d54-386421ac260d