Claims / RHP100202

RHP100202

Fernhollow Community Care. Visit on Jul 20, 2026 with Dr. Tomas Varga.

Paid as expected

Charged

$449.00

Contract expects

$145.86

Allowed per fee schedule

Payer allowed

$145.86

Payer paid

$145.86

Patient owes

$0.00

Deductible, coinsurance, copay

At stake

$0.00

What happened

Allowed at the contract rate and paid in full: $145.86.

Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999044410007C.

Next step

No action needed

Paid correctly.

Follow-up Resolved

Assigned to Lee Marsh

Send a corrected claim. Added the missing referring provider and resubmitted. Paid in full on the next payment. Dana Whitfield, Sep 14, 2026Payer reference # GPM-RC-30118

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
99204 New patient visit, moderate complexity	$408.00	$132.60	$132.60	$132.60	$0.00	CO-45 Above the contracted rate $275.40
93000 Electrocardiogram	$41.00	$13.26	$13.26	$13.26	$0.00	CO-45 Above the contracted rate $27.74

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The codes on this claim, explained

CO-45Above the contracted rateContract rate

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
Aug 3, 2026	99900004301	Denied	Superseded	$0.00
Sep 14, 2026	99900004410	Paid as expected	Current	$145.86

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As billed

Payer: Fernhollow Community Care
Date of service: Jul 20, 2026
Sent to payer: Jul 22, 2026
Provider: Dr. Tomas Varga
Location: Eastgate Family CareEastgate Family Care, East Region
Patient: SYN-0202 (synthetic reference)