Claim for Bo Gino Murazik — 2019-12-02

Patient

patient Bo Gino Murazik

Visit

visit Encounter for check up

Serviced

2019-12-02illness from the same day

Status

Closedlast billed 2019-12-02 · type 2

Diagnoses

diagnosis concept Gingivitiscode 66383009

Billed for

procedure concept resinbased composite, one surface posteriorcode D2391procedure concept intraoral, periapical first radiographic image · D0220

Coverage

payer Humana no secondary insurer

Outstanding

Nothing outstandingsettled in full