Claim total
$86.97
base $75.00 · payer covered $36.97
The visit
- Class
- Virtual
- Code
- 185317003
- Reason
- —
- Start
- 2024-03-28
- Stop
- 2024-03-28
The parties
- Patient
- patient Salvador Hernán Marrero
- Provider
- provider Heriberto Smitham
- Payer
- payer Medicaid
Record id
003934f5-fa99-8d07-7129-1be84688ba3b