Claim CLM-G0104599
$20.18
billed
$12.67
allowed
$0.00
paid
$0.00
patient responsibility
Adjudication lines
| Service | Code | Billed | Paid |
|---|---|---|---|
| Complete blood count | 85025 | $20.18 | $0.00 |
Denial risk — 17/99
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: 1589 of 8709 claims denied (18%) | +0.51 |
| Service 85025 (Complete blood count): 541 of 5958 historically denied (9%) | -0.04 |