Claim total
$1,211.64
base $93.83 · payer covered $969.31
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-06-08
- Stop
- 2026-06-08
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Samantha Schmidt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-5b22-b24c5cfc518c