Charged
$641.13
$641.13 paid
The claim
- Patient
- patient Pok Shane Strosin
- Visit
- visit Well child visit
- Serviced
- 2019-06-05illness from the same day
- Status
- Closedlast billed 2019-06-05 · type 1
- Billed for
- procedure concept Patient referral for dental carecode 103697008
Settlement
- Coverage
- payer Medicare secondary: payer Blue Cross Blue Shield
- Outstanding
- Nothing outstandingsettled in full
Record id
00162663-d9d1-4955-16c7-be892afc2b24