Claim CLM-2026146002
$16,911.26
billed
$15,427.19
allowed
$13,414.94
paid
$2,012.25
patient responsibility
Adjudication lines
| Service | Code | Billed | Paid |
|---|---|---|---|
| Prenatal visit (regime/therapy) | 424619006 | $0.00 | $0.00 |
| Evaluation of uterine fundal height (procedure) | 274804006 | $7,786.96 | $5,450.87 |
| Auscultation of the fetal heart (procedure) | 225158009 | $8,981.72 | $6,287.20 |