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Alexei Oliver Robinson MRN-232894 · born 2025-05-09 ✦ AI Ask ✦ AI Ambient note Chart

Claim CLM-G0149247

Alexei Oliver Robinson MRN-232894 Payer Medicaid Service Sep 19, 2024 Status paid
$114.68
billed
$72.72
allowed
$68.53
paid
$1.14
patient responsibility

Adjudication lines

ServiceCodeBilled Paid
Chest radiograph, 2 views71046 $114.68 $68.53