Charged
$93.39
$93.39 paid
The claim
- Patient
- patient Maria Dibbert
- Serviced
- 2002-01-28illness from the same day
- Status
- Closedlast billed 2002-01-28 · type 2
- Diagnoses
- diagnosis concept Gingivitiscode 66383009
Settlement
- Coverage
- payer Medicare secondary: payer Blue Cross Blue Shield
- Outstanding
- Nothing outstandingsettled in full
Record id
000287f5-a0d8-f77b-4ddd-2c7648966418