Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-02-16
- Stop
- 2017-02-16
The parties
- Patient
- patient Manual Jack Rolfson
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer No insurance
Record id
08e1cdf3-4764-d0af-3fda-760c5ef705fe