Claims / RHP100232
RHP100232
Granite Plains Mutual. Visit on Aug 5, 2026 with Maya Chen, NP.
Paid as expected
Charged
$624.00
Contract expects
$306.80
Allowed per fee schedule
Payer allowed
$306.80
Payer paid
$306.80
Patient owes
$0.00
Deductible, coinsurance, copay
At stake
$0.00
What happened
- Allowed at the contract rate and paid in full: $306.80.
Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999020631007C.
Next step
No action needed
Paid correctly.
Follow-up Resolved
Assigned to Lee Marsh
Appeal. Sent the approved authorization. Granite Plains reprocessed and paid at the contract rate. Dana Whitfield, Sep 28, 2026Payer reference # GPM-APL-30402Link (portal.graniteplains.example)
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 |
|---|---|---|---|---|---|---|
| 73721 MRI of a leg joint | $624.00 | $306.80 | $306.80 | $306.80 | $0.00 |
|
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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| Aug 17, 2026 | GP99900000544 | Denied | Superseded | $0.00 |
| Sep 28, 2026 | GP99900000631 | Paid as expected | Current | $306.80 |
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As billed
- Date of service
- Aug 5, 2026
- Sent to payer
- Aug 7, 2026
- Provider
- Maya Chen, NP
- Location
- Main CampusMain Campus, East Region
- Patient
- SYN-0232 (synthetic reference)