Claim total
$291.66
base $155.66 · payer covered $233.33
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-07-26
- Stop
- 2021-07-26
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Burton O'Conner
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-f389-fe0f9799c3c9