Claim total
$1,816.03
base $155.66 · payer covered $1,816.03
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-12-01
- Stop
- 2025-12-01
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Penni Kuphal
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Aetna
Record id
006af299-d813-2b4f-a45b-aade2eb23976