Claim CLM-G0107204
$279.18
billed
$241.82
allowed
$0.00
paid
$0.00
patient responsibility
Adjudication lines
| Service | Code | Billed | Paid |
|---|---|---|---|
| Office visit, new patient | 99204 | $246.84 | $0.00 |
| Hemoglobin A1c | 83036 | $32.34 | $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 |
|---|---|
| Medicare denial history: 732 of 7959 claims denied (9%) | +0.01 |
| Service 83036 (Hemoglobin A1c): 556 of 5992 historically denied (9%) | +0.00 |