Charged
$148.50
$148.50 paid
The claim
- Patient
- patient Caitlyn Elli Kuhlman
- Serviced
- 2016-11-15illness from the same day
- Status
- Closedlast billed 2016-11-15 · type 2
- Diagnoses
- diagnosis concept Viral sinusitiscode 444814009
- Billed for
- medication concept Amoxicillin 250 MG / Clavulanate 125 MG Oral Tabletcode 562251
Settlement
- Coverage
- Self-pay no insurer on this claim
- Outstanding
- Nothing outstandingsettled in full
Record id
0037332a-29d1-a298-b191-20caec2e3773