Charged
$641.13
$641.13 paid
The claim
- Patient
- patient Salvador Hernán Marrero
- Visit
- visit Well child visit
- Serviced
- 2023-11-02illness from the same day
- Status
- Closedlast billed 2023-11-02 · 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-c589-74aea97b70d1