Claim total
$12,627.50
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2026-06-23
- Stop
- 2026-06-23
The parties
- Patient
- patient Rhoda Tawnya Hermiston
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
1d8a9aef-71b5-3301-02a2-7cb0c505d3c7