Charged
$505.13
$505.13 paid
The claim
- Patient
- patient Salvador Hernán Marrero
- Visit
- visit Well child visit
- Serviced
- 2022-10-27illness from the same day
- Status
- Closedlast billed 2022-10-27 · type 1
- Diagnoses
- diagnosis concept Gingivitiscode 66383009
- Billed for
- procedure concept Patient referral for dental carecode 103697008
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003934f5-fa99-8d07-9709-84b06bab0f57