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Claim

Claim for Donny Wilfred Ruecker — 2004-06-09

One bill, raised by a visit or a prescription.

Neighborhood Provenance
Charged
$1,080.81
$1,080.81 paid

The claim

Patient
patient Donny Wilfred Ruecker
Visit
visit General examination of patient
Serviced
2004-06-09illness from the same day
Status
Closedlast billed 2004-06-09 · type 1
Diagnoses
diagnosis concept Stresscode 73595000
Billed for
medication concept insulin isophane, human 70 UNT/ML / insulin, regular, human 30 UNT/ML Injectable Suspension [Humulin]code 106892

Settlement

Coverage
payer Medicare secondary: payer Blue Cross Blue Shield
Outstanding
Nothing outstandingsettled in full
Record id 0054427e-44d7-94b2-12f9-1b3014dca21b