Charged
$225.53
$225.53 paid
The claim
- Patient
- patient Dora Violet Okuneva
- Serviced
- 2026-01-24illness from 2016-09-23
- Status
- Closedlast billed 2026-01-24 · type 2
- Diagnoses
- diagnosis concept Lupus erythematosuscode 200936003
- Billed for
- medication concept cycloSPORINE, modified 100 MG Oral Capsulecode 241834
Settlement
- Coverage
- payer Anthem no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
001727b6-dbde-2493-c1cc-b4120774fc5c