Charged
$99.52
$99.52 paid
The claim
- Patient
- patient Adam Jones
- Serviced
- 2018-05-07illness from the same day
- Status
- Closedlast billed 2018-05-07 · type 2
- Diagnoses
- diagnosis concept Homelesscode 32911000
- Billed for
- procedure concept periodic oral evaluation, established patientcode D0120
Settlement
- Coverage
- payer Anthem no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
00229130-e769-8779-ccef-e4c759f3b60d