Claim total
$163.56
base $93.39 · payer covered $128.56
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2026-01-11
- Stop
- 2026-01-11
The parties
- Provider
- provider Heriberto Smitham
- Payer
- payer Dual Eligible
Record id
014b9cfb-a71a-d032-1067-570603e34afa