Charged
$95.12
$95.12 paid
The claim
- Patient
- patient Maria Dibbert
- Serviced
- 2021-12-20illness from the same day
- Status
- Closedlast billed 2021-12-20 · type 1
- Diagnoses
- diagnosis concept Full-time employmentcode 160903007diagnosis concept Limited social contact · 423315002
- Billed for
- medication concept albuterol 5 MG/ML Inhalation Solutioncode 245314
Settlement
- Coverage
- payer Medicare secondary: payer Blue Cross Blue Shield
- Outstanding
- Nothing outstandingsettled in full
Record id
000287f5-a0d8-f77b-90cc-91454cae33b3