Charged
$169.28
$169.28 paid
The claim
- Patient
- patient Dora Violet Okuneva
- Serviced
- 2019-07-06illness from the same day
- Status
- Closedlast billed 2019-07-06 · type 2
- Diagnoses
- diagnosis concept Gingivitiscode 66383009
- Billed for
- procedure concept bitewings, four radiographic imagescode D0274
Settlement
- Coverage
- payer Anthem no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
001727b6-dbde-2493-29af-0264f542e0c5