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Claim

Claim for Caitlyn Elli Kuhlman — 2019-01-01

One bill, raised by a visit or a prescription.

Neighborhood Provenance
Charged
$259.45
$259.45 paid

The claim

Patient
patient Caitlyn Elli Kuhlman
Visit
visit Encounter for check up
Serviced
2019-01-01illness from the same day
Status
Closedlast billed 2019-01-02 · type 2
Diagnoses
diagnosis concept Gingivitiscode 66383009
Billed for
procedure concept topical application of fluoride varnishcode D1206procedure concept prophylaxis, adult · D1110procedure concept intraoral, periapical each additional radiographic image · D0230

Settlement

Coverage
Self-pay no insurer on this claim
Outstanding
Nothing outstandingsettled in full
Record id 0037332a-29d1-a298-f498-cee0e0274b9b