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In context Kavya Oksana Mehta MRN-212067 · born 1946-12-22 ✦ AI Ask ✦ AI Ambient note Chart

Claim CLM-G0116883

Kavya Oksana Mehta MRN-212067 Payer Medicare Service Nov 19, 2024 Status paid
$18.03
billed
$10.81
allowed
$12.64
paid
$0.00
patient responsibility

Adjudication lines

ServiceCodeBilled Paid
Complete blood count85025 $18.03 $12.64