Claim total
$2,444.81
base $155.66 · payer covered $2,444.81
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2025-08-25
- Stop
- 2025-08-25
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Lanora Schowalter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Aetna
Record id
006af299-d813-2b4f-285e-9faba9e463e6