Charged
$97.60
$97.60 paid
The claim
- Patient
- patient Salvador Hernán Marrero
- Serviced
- 2023-10-24illness from the same day
- Status
- Closedlast billed 2023-10-24 · type 2
- Diagnoses
- diagnosis concept Acute bronchitiscode 10509002
- Billed for
- medication concept Acetaminophen 325 MG Oral Tabletcode 313782
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003934f5-fa99-8d07-bb1d-4939f759a103