Claim total
$1,829.54
base $155.66 · payer covered $700.98
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-03-17
- Stop
- 2025-03-17
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Pasquale Grimes
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-e517-e8f1a4843cd5