Claim total
$1,891.01
base $93.39 · payer covered $1,856.01
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-04-27
- Stop
- 2025-04-28
The parties
- Provider
- provider Heriberto Smitham
- Payer
- payer Dual Eligible
Record id
014b9cfb-a71a-d032-f9c8-ed65c9ec5c6a