Charged
$276.54
$276.54 paid
The claim
- Patient
- patient Xuan Collier
- Serviced
- 2020-07-20illness from the same day
- Status
- Closedlast billed 2020-07-28 · type 1
- Diagnoses
- diagnosis concept Sepsiscode 91302008diagnosis concept Acute respiratory distress syndrome · 67782005
- Billed for
- medication concept 150 ML vancomycin 5 MG/ML Injectioncode 1807510
Settlement
- Coverage
- payer Humana no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
002d4429-df26-5797-1b33-1e79702df1b1