Claim total
$353.23
base $93.39 · payer covered $303.23
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2023-11-16
- Stop
- 2023-11-16
The parties
- Patient
- patient Salvador Hernán Marrero
- Provider
- provider Heriberto Smitham
- Payer
- payer Medicaid
Record id
003934f5-fa99-8d07-9a27-561fd6a13062