Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2019-07-30
- Stop
- 2019-07-30
The parties
- Patient
- patient Malvina Deanne Jacobi
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
0f81015e-ddeb-f808-e2df-d4b90f0c0758