Charged
$640.69
$640.69 paid
The claim
- Patient
- patient Salvador Hernán Marrero
- Serviced
- 2022-05-26illness from the same day
- Status
- Closedlast billed 2022-05-26 · type 2
- 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-fa99-8d07-9180-b6cbfa30b13a