Claim total
$2,793.27
base $155.66 · payer covered $2,793.27
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2026-03-02
- Stop
- 2026-03-02
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-debe-1af71f96ed60