Claim for Maria Dibbert — 2026-01-26

Patient

patient Maria Dibbert

Visit

visit Encounter for check up

Serviced

2026-01-26illness from the same day

Status

Closedlast billed 2026-01-26 · type 2

Diagnoses

diagnosis concept Fractured dental restorative material with loss of materialcode K08.531

Billed for

procedure concept cone beam CT image capture with field of view of both jaws; with or without craniumcode D0383

Coverage

payer Medicare secondary: payer Blue Cross Blue Shield

Outstanding

Nothing outstandingsettled in full