Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2025-12-02
- Stop
- 2025-12-02
The parties
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
06444eb9-3bbb-5546-ed8b-23c7cf13327e