φ(ai) PHI AI
DocumentationDocs
Repository
In context
Rachel Vera Reddy MRN-218684 · born 1990-03-22 ✦ AI Ask ✦ AI Ambient note Chart

Claim CLM-G0127248

Rachel Vera Reddy MRN-218684 Payer Blue Cross Blue Shield Service Nov 15, 2023 Status paid
$180.87
billed
$128.18
allowed
$114.81
paid
$3.53
patient responsibility

Adjudication lines

ServiceCodeBilled Paid
Telehealth visit, level 399213 $145.27 $86.78
Hemoglobin A1c83036 $35.60 $28.03