Charged
$180.13
$180.13 paid
The claim
- Patient
- patient Emery Herbert Steuber
- Serviced
- 2021-04-08illness from the same day
- Status
- Closedlast billed 2021-04-09 · type 2
- Diagnoses
- diagnosis concept Gingivitiscode 66383009
- Billed for
- procedure concept resinbased composite, three surfaces anteriorcode D2332
Settlement
- Coverage
- payer Blue Cross Blue Shield no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003012ce-f819-e17b-fcca-0ea9969d11a5