Claim for Donny Wilfred Ruecker — 2004-05-05

Patient

patient Donny Wilfred Ruecker

Visit

visit Encounter for check up

Serviced

2004-05-05illness from the same day

Status

Closedlast billed 2004-05-05 · type 1

Diagnoses

diagnosis concept Medication review duecode 314529007

Billed for

medication concept insulin isophane, human 70 UNT/ML / insulin, regular, human 30 UNT/ML Injectable Suspension [Humulin]code 106892

Coverage

payer Medicare secondary: payer Blue Cross Blue Shield

Outstanding

Nothing outstandingsettled in full