Charged
$1,137.75
$1,137.75 paid
The claim
- Patient
- patient Ronnie Ina Gusikowski
- Visit
- visit Well child visit
- Serviced
- 1975-06-13illness from the same day
- Status
- Closedlast billed 1975-06-13 · type 1
- Billed for
- procedure concept Medication reconciliationcode 430193006procedure concept Depression screening · 171207006procedure concept Depression screening using Patient Health Questionnaire Nine Item score · 715252007procedure concept Assessment of substance use · 428211000124100
2 more billed codes
procedure concept Assessment using Car, Relax, Alone, Forget, Friends, Trouble Screening Test · 868187001procedure concept Anticipatory guidance · 386516004
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003b30a0-7fd2-f42c-14c4-3f9a0aaae63e