Claim total
$3,593.18
base $155.66 · payer covered $2,874.55
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-09-15
- Stop
- 2025-09-15
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Jo Stiedemann
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-92f4-e8a7da0f4843