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Daniel Chen Merriweather MRN-202387 · born 1999-12-14 ✦ AI Ask ✦ AI Ambient note Chart

Claim CLM-G0101853

Daniel Chen Merriweather MRN-202387 Payer Medicaid Service May 11, 2024 Status paid
$248.14
billed
$150.64
allowed
$164.56
paid
$0.00
patient responsibility

Adjudication lines

ServiceCodeBilled Paid
Office visit, new patient99204 $248.14 $164.56