Claim total
$1,361.07
base $127.17 · payer covered $1,088.86
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of mandible263172003
- Start
- 2022-08-10
- Stop
- 2022-08-10
The parties
- Patient
- patient Garland Diego Schulist
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer UnitedHealthcare
Record id
319f1704-a8bc-41b4-6e96-14e0690573bb