Charged
$93.39
$93.39 paid
The claim
- Patient
- patient Adam Jones
- Serviced
- 1986-04-21illness from the same day
- Status
- Closedlast billed 1986-04-21 · type 2
- Diagnoses
- diagnosis concept Acute gingivitiscode 31642005
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
00229130-e769-8779-845a-809015f7353d