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Claim CLM-40031
RejectedWLP-DISCONNECTClient
Program
Employment
Payer
DVR — Employment Grant
Service Date Range
Aug 22, 2026 – Aug 22, 2026
Total Units
4
Billed
$112
Paid
—
Created
Aug 23, 2026
Submitted
Aug 24, 2026
| Note ID | Client | Service Date | Code | Units | Amount | Staff | Approval Date |
|---|---|---|---|---|---|---|---|
| CN-25999 | Olivia Iverson | Aug 22, 2026 | H2015 | 4 | $112 | Marcus Holt | Aug 22, 2026 |
| Totals | 4 | $112 | |||||