Charged
$135.77
$135.77 paid
The claim
- Patient
- patient Bo Gino Murazik
- Serviced
- 2018-11-26illness from the same day
- Status
- Closedlast billed 2018-11-26 · type 2
- Diagnoses
- diagnosis concept Gingivitiscode 66383009
- Billed for
- procedure concept periodic oral evaluation, established patientcode D0120
Settlement
- Coverage
- payer Humana no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003af57f-1886-144b-4995-e85ac9fc5884