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Claim

Claim for Ronnie Ina Gusikowski — 1977-03-11

One bill, raised by a visit or a prescription.

Charged
$93.83
$93.83 paid

The claim

Serviced
1977-03-11illness from 1977-02-26
Status
Billedlast billed 1977-03-11 · type 1
Diagnoses
diagnosis concept Bullet woundcode 262574004

Settlement

Coverage
payer Medicaid no secondary insurer
Outstanding
$107.11$50.00 owed by the patient
Record id 003b30a0-7fd2-f42c-d929-696e7b42e6a5