Charged
$97.60
$97.60 paid
The claim
- Patient
- patient Maria Dibbert
- Serviced
- 2022-08-04illness from the same day
- Status
- Closedlast billed 2022-08-04 · type 2
- Diagnoses
- diagnosis concept Acute bronchitiscode 10509002
- Billed for
- medication concept Acetaminophen 325 MG Oral Tabletcode 313782
Settlement
- Coverage
- payer Medicare secondary: payer Blue Cross Blue Shield
- Outstanding
- Nothing outstandingsettled in full
Record id
000287f5-a0d8-f77b-74d7-a3541cdde7c9