Claim total
$1,212.29
base $155.66 · payer covered $1,212.29
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2023-09-11
- Stop
- 2023-09-11
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Pasquale Grimes
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-dc62-2a5926cc6613