φ(ai) PHI AI
DocumentationDocs
Repository
In context Hyun Clark MRN-229658 · born 1966-11-26 ✦ AI Ask ✦ AI Ambient note Chart

Claim CLM-G0144266

Hyun Clark MRN-229658 Payer Medicaid Service Dec 4, 2025 Status paid
$265.77
billed
$223.45
allowed
$205.85
paid
$6.87
patient responsibility

Adjudication lines

ServiceCodeBilled Paid
Telehealth visit, level 399213 $148.37 $108.03
Telehealth visit, level 399213 $117.40 $97.82