LEGACY-55120
Paid by Granite Plains Mutual, but no claim with this number was billed.
What happened
- This payment of $108.56 could not be tied to a billed claim, so it cannot be checked against the contract or posted safely.
No billed claim found. Payer status: Processed as primary. Payer claim number 999020631002.
Next step
Find the claim in the practice system before posting this money, or it lands on the wrong account.
Assigned to Nobody yet
Nobody has recorded a follow-up yet.
Line by line
What was billed, what the contract says, and what the payer did with each service.
| Service | Charged | Contract | Allowed | Paid | Patient | Adjustments |
|---|---|---|---|---|---|---|
| 99213 Established patient visit, low complexity | $221.00 | No rate | $108.56 | $108.56 | $0.00 |
|
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The codes on this claim, explained
The charge is higher than the fee schedule or contracted amount. The difference is written off.
Contractual obligation: The practice absorbs this amount under its contract or the payer rules. It may not be billed to the patient.
Usual fix: Expected. Only a problem if the allowed amount is below your contract rate.
Payment history
Every remittance that answered this claim, oldest first.
| Paid | Payment | Result | Status | Paid |
|---|---|---|---|---|
| Sep 28, 2026 | GP99900000631 | Unmatched | Current | $108.56 |
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