Claim for Ronnie Ina Gusikowski — 1976-06-18

Patient

patient Ronnie Ina Gusikowski

Visit

visit Well child visit

Serviced

1976-06-18illness from the same day

Status

Closedlast billed 1976-06-18 · type 1

Diagnoses

diagnosis concept Medication review duecode 314529007diagnosis concept Gingivitis · 66383009

Billed for

procedure concept Medication reconciliationcode 430193006procedure concept Depression screening · 171207006procedure concept Depression screening using Patient Health Questionnaire Nine Item score · 715252007procedure concept Assessment of substance use · 428211000124100

3 more billed codes

procedure concept Assessment using Car, Relax, Alone, Forget, Friends, Trouble Screening Test · 868187001procedure concept Anticipatory guidance · 386516004procedure concept Patient referral for dental care · 103697008

Coverage

payer Medicaid no secondary insurer

Outstanding

Nothing outstandingsettled in full