Claim total
$2,293.54
base $155.66 · payer covered $2,293.54
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2023-12-18
- Stop
- 2023-12-18
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Leta Sipes
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-06f5-86a3c5c141e5