Claim for Nona Samara Gleichner — 2018-10-28

Patient

patient Nona Samara Gleichner

Visit

visit Encounter for symptom

Serviced

2018-10-28illness from the same day

Status

Closedlast billed 2018-10-28 · type 2

Diagnoses

diagnosis concept Acute bronchitiscode 10509002

Billed for

medication concept Acetaminophen 21.7 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML / doxylamine succinate 0.417 MG/ML Oral Solutioncode 1043400

Coverage

payer Humana no secondary insurer

Outstanding

Nothing outstandingsettled in full