Charged
$93.39
$93.39 paid
The claim
- Patient
- patient Leigh Weston Lubowitz
- Serviced
- 2004-06-15illness from the same day
- Status
- Closedlast billed 2004-06-15 · type 2
- Diagnoses
- diagnosis concept Impacted toothcode 235104008
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
0031d341-6ceb-7483-550d-500d441385c4