Claim total
$949.77
base $127.17 · payer covered $371.26
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2021-11-09
- Stop
- 2021-11-09
The parties
- Patient
- patient Tristan Chase Moore
- Provider
- provider Jeremy Veum
- Care site
- care site THE VILLA AT BRYN MAWR
- Payer
- payer UnitedHealthcare
Record id
3ac7a739-3886-4d55-8ef1-bd515de020ae