Claim total
$4,019.43
base $155.66 · payer covered $3,215.55
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2025-06-16
- Stop
- 2025-06-16
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Trinity Mraz
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-9645-e1eb72fb1bc7