Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Asthma195967001
- Start
- 2025-07-09
- Stop
- 2025-07-09
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Trinity Mraz
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-f4f3-9c345457ef03