Claim CLM-2026951004
$85.55
billed
$3,052.67
allowed
$2,654.50
paid
$398.17
patient responsibility
Adjudication lines
| Service | Code | Billed | Paid |
|---|---|---|---|
| Encounter for check up (procedure) | 185349003 | $0.00 | $0.00 |
| Stress (finding) | 73595000 | $0.00 | $0.00 |
| Assessment of anxiety (procedure) | 710841007 | $431.40 | $301.98 |
| Generalized anxiety disorder 7 item (GAD-7) | 69737-5 | $74.58 | $52.21 |