Claim total
$3,883.80
base $155.66 · payer covered $3,107.04
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2024-09-05
- Stop
- 2024-09-05
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Jo Stiedemann
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-63d9-d35307248d6b