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Claim CLM-40023
AcceptedClient
Program
Employment
Payer
DVR — Employment Grant
Service Date Range
Aug 27, 2026 – Aug 27, 2026
Total Units
4
Billed
$112
Paid
—
Created
Aug 30, 2026
Submitted
Aug 31, 2026
| Note ID | Client | Service Date | Code | Units | Amount | Staff | Approval Date |
|---|---|---|---|---|---|---|---|
| CN-26003 | Sofia Cruz | Aug 27, 2026 | H2015 | 4 | $112 | Priya Shah | Aug 27, 2026 |
| Totals | 4 | $112 | |||||