Claim CLM-G0144266
$265.77
billed
$223.45
allowed
$205.85
paid
$6.87
patient responsibility
Adjudication lines
| Service | Code | Billed | Paid |
|---|---|---|---|
| Telehealth visit, level 3 | 99213 | $148.37 | $108.03 |
| Telehealth visit, level 3 | 99213 | $117.40 | $97.82 |
| Service | Code | Billed | Paid |
|---|---|---|---|
| Telehealth visit, level 3 | 99213 | $148.37 | $108.03 |
| Telehealth visit, level 3 | 99213 | $117.40 | $97.82 |