Claim CLM-G0100079
$246.82
billed
$153.46
allowed
$0.00
paid
$0.00
patient responsibility
Adjudication lines
| Service | Code | Billed | Paid |
|---|---|---|---|
| Office visit, new patient | 99204 | $212.20 | $0.00 |
| Comprehensive metabolic panel | 80053 | $34.62 | $0.00 |
Denial risk — 9/99
Scored by the denial-risk model before adjudication. Advisory only — nothing blocks on a score; the factors below cite the adjudication history they came from.
| Factor | Weight |
|---|---|
| UnitedHealthcare denial history: 773 of 8195 claims denied (9%) | +0.04 |
| Service 80053 (Comprehensive metabolic panel): 540 of 5985 historically denied (9%) | 0.00 |