Claim total
$93.58
base $93.39 · payer covered $58.58
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2021-12-26
- Stop
- 2021-12-26
The parties
- Provider
- provider Heriberto Smitham
- Payer
- payer Dual Eligible
Record id
014b9cfb-a71a-d032-cb4b-180b39c888b1