Charged
$353.23
$353.23 paid
The claim
- Patient
- patient Salvador Hernán Marrero
- Serviced
- 2023-11-16illness from the same day
- Status
- Closedlast billed 2023-11-16 · type 2
- Diagnoses
- diagnosis concept Gingivitiscode 66383009
- Billed for
- procedure concept resinbased composite, two surfaces posteriorcode D2392
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003934f5-fa99-8d07-7a50-20f78d08c929