Charged
$1,122.75
$1,122.75 paid
The claim
- Patient
- patient Ronnie Ina Gusikowski
- Serviced
- 1968-03-17illness from the same day
- Status
- Closedlast billed 1968-03-17 · type 2
- Diagnoses
- diagnosis concept Otitis mediacode 65363002
- Billed for
- medication concept Doxycycline Monohydrate 50 MG Oral Tabletcode 1652673
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003b30a0-7fd2-f42c-e912-3764d7ddb861