Charged
$195.74
$195.74 paid
The claim
- Patient
- patient Ronnie Ina Gusikowski
- Serviced
- 1970-01-30illness from the same day
- Status
- Closedlast billed 1970-01-30 · type 2
- Diagnoses
- diagnosis concept Streptococcal sore throatcode 43878008
- Billed for
- medication concept Penicillin V Potassium 250 MG Oral Tabletcode 834061
Settlement
- Coverage
- payer Medicaid no secondary insurer
- Outstanding
- Nothing outstandingsettled in full
Record id
003b30a0-7fd2-f42c-6684-27374ccc6578