Claim CLM-G0127247
$50.74
billed
$29.80
allowed
$41.47
paid
$0.00
patient responsibility
Adjudication lines
| Service | Code | Billed | Paid |
|---|---|---|---|
| Electrocardiogram, routine | 93000 | $50.74 | $41.47 |
| Service | Code | Billed | Paid |
|---|---|---|---|
| Electrocardiogram, routine | 93000 | $50.74 | $41.47 |