Claim total
$994.93
base $93.39 · payer covered $944.93
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-10-11
- Stop
- 2018-10-11
The parties
- Patient
- patient Salvador Hernán Marrero
- Provider
- provider Heriberto Smitham
- Payer
- payer Medicaid
Record id
003934f5-fa99-8d07-b87e-5e11c9192486