Claim for Caitlyn Elli Kuhlman — 2013-05-14

Patient

patient Caitlyn Elli Kuhlman

Visit

visit Encounter for check up

Serviced

2013-05-14illness from the same day

Status

Closedlast billed 2013-05-15 · type 2

Diagnoses

diagnosis concept Gingivitiscode 66383009

Billed for

procedure concept periodic oral evaluation, established patientcode D0120procedure concept intraoral, periapical first radiographic image · D0220procedure concept intraoral, periapical each additional radiographic image · D0230procedure concept oral hygiene instructions · D1330

1 more billed code

procedure concept topical application of fluoride, excluding varnish · D1208

Coverage

Self-pay no insurer on this claim

Outstanding

Nothing outstandingsettled in full