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In context Rolf Marlin Grant MRN-106857 · born 1935-05-13 ✦ AI Ask ✦ AI Ambient note Chart

Claim CLM-2026951007

Rolf Marlin Grant MRN-106857 Payer Humana Service Apr 5, 2026 Status paid
$1,199.60
billed
$839.72
allowed
$0.00
paid
$839.72
patient responsibility

Adjudication lines

ServiceCodeBilled Paid
Digoxin 0.125 MG Oral Tablet197604 $0.00 $0.00