Claim total
$96.43
base $93.39 · payer covered $46.43
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2022-11-03
- Stop
- 2022-11-03
The parties
- Patient
- patient Salvador Hernán Marrero
- Provider
- provider Heriberto Smitham
- Payer
- payer Medicaid
Record id
003934f5-fa99-8d07-4e38-a24da5766e74