Claim total
$3,935.75
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2026-03-25
- Stop
- 2026-03-25
The parties
- Patient
- patient Russ Nicholas Hagenes
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
1b3c58af-4749-b693-3932-99285c52df66