Claim total
$127.17
base $127.17 · payer covered $72.83
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2023-03-29
- Stop
- 2023-03-29
The parties
- Patient
- patient Santiago Víctor Cavazos
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicare
Record id
157c2e9c-d23e-1a11-546d-3482a6d703fb