Claim total
$1,093.63
base $127.17 · payer covered $1,058.63
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2024-05-03
- Stop
- 2024-05-03
The parties
- Patient
- patient Vito Glenn Medhurst
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Dual Eligible
Record id
26ddb759-380a-cffb-630d-79db8aabc4ba