Claim for Pok Shane Strosin — 2019-06-12

Patient

patient Pok Shane Strosin

Visit

visit Encounter for check up

Serviced

2019-06-12illness from the same day

Status

Closedlast billed 2019-06-12 · type 2

Billed for

procedure concept limited oral evaluation, problem focusedcode D0140procedure concept extraction, erupted tooth or exposed root (elevation and/or forceps removal) · D7140

Coverage

payer Medicare secondary: payer Blue Cross Blue Shield

Outstanding

Nothing outstandingsettled in full