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Claim

Claim for Maria Dibbert — 2021-12-20

One bill, raised by a visit or a prescription.

Neighborhood Provenance
Charged
$1,061.14
$1,061.14 paid

The claim

Patient
patient Maria Dibbert
Visit
visit General examination of patient
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 60 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhalercode 896209

Settlement

Coverage
payer Medicare secondary: payer Blue Cross Blue Shield
Outstanding
Nothing outstandingsettled in full
Record id 000287f5-a0d8-f77b-e38d-52b245708baa