Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-12-02
- Stop
- 2025-12-02
The parties
- Patient
- patient Damon Hai Zulauf
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer Medicaid
Record id
304fb1b6-3c73-bae9-9e25-8670c01cb0c3