RHP100632
Fernhollow Community Care. Visit on Aug 20, 2026 with Dr. Alana Reyes.
What happened
- Allowed at the contract rate and paid in full: $87.36.
Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999044410040.
Next step
Paid correctly.
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 |
|---|---|---|---|---|---|---|
| 99203 New patient visit, low complexity | $269.00 | $87.36 | $87.36 | $87.36 | $0.00 |
|
Scroll sideways to see every column.
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 15, 2026 | 99900004410 | Paid as expected | Current | $87.36 |
Scroll sideways to see every column.
As billed
- Date of service
- Aug 20, 2026
- Sent to payer
- Aug 22, 2026
- Provider
- Dr. Alana Reyes
- Location
- Main CampusMain Campus, East Region
- Patient
- SYN-0632 (synthetic reference)