Charged
$1,167.26
$1,167.26 paid
The claim
- Patient
- patient Pok Shane Strosin
- Visit
- visit Well child visit
- Serviced
- 2023-06-28illness from the same day
- Status
- Closedlast billed 2023-06-28 · type 1
- Diagnoses
- diagnosis concept Medication review duecode 314529007diagnosis concept Gingivitis · 66383009
- Billed for
- procedure concept Medication reconciliationcode 430193006procedure concept Patient referral for dental care · 103697008
Settlement
- Coverage
- payer Medicare no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
00162663-d9d1-4955-2070-b8049b6820ea