Charged
$641.13
$641.13 paid
The claim
- Patient
- patient Xuan Collier
- Visit
- visit Well child visit
- Serviced
- 2013-05-12illness from the same day
- Status
- Closedlast billed 2013-05-12 · type 1
- Diagnoses
- diagnosis concept Acute infective cystitiscode 307426000
- Billed for
- procedure concept Assessment of anxietycode 710841007procedure concept Depression screening · 171207006procedure concept Depression screening using Patient Health Questionnaire Nine Item score · 715252007procedure concept Assessment of substance use · 428211000124100
2 more billed codes
procedure concept Assessment using Car, Relax, Alone, Forget, Friends, Trouble Screening Test · 868187001procedure concept Anticipatory guidance · 386516004
Settlement
- Coverage
- payer Humana no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
002d4429-df26-5797-8998-0fca2d5f8a97