Claim CLM-G0102757
$220.22
billed
$190.86
allowed
$0.00
paid
$0.00
patient responsibility
Adjudication lines
| Service | Code | Billed | Paid |
|---|---|---|---|
| Electrocardiogram, routine | 93000 | $73.98 | $0.00 |
| Chest radiograph, 2 views | 71046 | $146.24 | $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 |
|---|---|
| Medicaid denial history: 800 of 8709 claims denied (9%) | +0.01 |
| Service 71046 (Chest radiograph, 2 views): 579 of 5968 historically denied (10%) | +0.01 |