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Claim CLM-40030
RejectedPR-MEDELIGClient
Program
Housing
Payer
Medicaid — WA
Service Date Range
Aug 20, 2026 – Aug 20, 2026
Total Units
4
Billed
$88
Paid
—
Created
Aug 21, 2026
Submitted
Aug 22, 2026
| Note ID | Client | Service Date | Code | Units | Amount | Staff | Approval Date |
|---|---|---|---|---|---|---|---|
| CN-25998 | Camila Morales | Aug 20, 2026 | H0043 | 4 | $88 | Sam Park | Aug 20, 2026 |
| Totals | 4 | $88 | |||||