Claims / RHP100642

RHP100642

Fernhollow Community Care. Visit on Aug 28, 2026 with Maya Chen, NP.

Paid as expected

Charged

$319.00

Contract expects

$103.74

Allowed per fee schedule

Payer allowed

$103.74

Payer paid

$103.74

Patient owes

$0.00

Deductible, coinsurance, copay

At stake

$0.00

What happened

Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999044410050.

No action needed

Paid correctly.

Follow-up

Assigned to Nobody yet

Nobody has recorded a follow-up yet.

What was billed, what the contract says, and what the payer did with each service.

Service	Charged	Contract	Allowed	Paid	Patient	Adjustments
99214 Established patient visit, moderate complexity	$312.00	$101.40	$101.40	$101.40	$0.00	CO-45 Above the contracted rate $210.60
36415 Blood draw	$7.00	$2.34	$2.34	$2.34	$0.00	CO-45 Above the contracted rate $4.66

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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.

Every remittance that answered this claim, oldest first.

Paid	Payment	Result	Status	Paid
Sep 15, 2026	99900004410	Paid as expected	Current	$103.74

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