Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2004-04-21
- Stop
- 2004-04-21
The parties
- Patient
- patient Kareen Pfeffer
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
14e28a38-73f9-f96b-0ff5-d3681179060e