Charged
$161.71
$161.71 paid
The claim
- Patient
- patient Nona Samara Gleichner
- Serviced
- 2025-08-13illness from the same day
- Status
- Closedlast billed 2025-08-13 · type 2
- Diagnoses
- diagnosis concept Gingivitiscode 66383009
- Billed for
- procedure concept topical application of fluoride varnishcode D1206
Settlement
- Coverage
- payer Humana no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
0042ca65-dd9d-7221-0e9d-2cb7ee6b04a2