Claim total
$1,212.29
base $155.66 · payer covered $969.83
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-12-15
- Stop
- 2025-12-15
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Burton O'Conner
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-9616-ad19b9ed7d6e