Charged
$390.49
$390.49 paid
The claim
- Patient
- patient Emery Herbert Steuber
- Serviced
- 2024-04-18illness from the same day
- Status
- Closedlast billed 2024-04-18 · type 2
- Diagnoses
- diagnosis concept Viral sinusitiscode 444814009
- Billed for
- medication concept Amoxicillin 250 MG / Clavulanate 125 MG Oral Tabletcode 562251
Settlement
- Coverage
- payer Blue Cross Blue Shield no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003012ce-f819-e17b-59c6-3ea9d509972e