Charged
$96.43
$96.43 paid
The claim
- Patient
- patient Salvador Hernán Marrero
- Serviced
- 2022-11-03illness from the same day
- Status
- Closedlast billed 2022-11-03 · type 2
- Diagnoses
- diagnosis concept Gingivitiscode 66383009
- Billed for
- procedure concept periodic orthodontic treatment visitcode D8670
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003934f5-fa99-8d07-c905-a5809e492348