Charged
$113.05
$113.05 paid
The claim
- Patient
- patient Salvador Hernán Marrero
- Serviced
- 2021-10-28illness from the same day
- Status
- Closedlast billed 2021-10-28 · type 2
- Billed for
- procedure concept comprehensive oral evaluation, new or established patientcode D0150
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003934f5-fa99-8d07-ef16-266b116a21e4