Claims / RHP101214

RHP101214

Granite Plains Mutual. Visit on Jul 23, 2026 with Dr. Priya Raman.

Paid as expected

Charged

$310.00

Contract expects

$152.22

Allowed per fee schedule

Payer allowed

$152.22

Payer paid

$152.22

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 999020544017.

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
99213 Established patient visit, low complexity	$221.00	$108.56	$108.56	$108.56	$0.00	CO-45 Above the contracted rate $112.44
90471 Vaccine administration	$41.00	$20.06	$20.06	$20.06	$0.00	CO-45 Above the contracted rate $20.94
90686 Flu vaccine	$48.00	$23.60	$23.60	$23.60	$0.00	CO-45 Above the contracted rate $24.40

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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
Aug 18, 2026	GP99900000544	Paid as expected	Current	$152.22

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