Claims / RHP101247

RHP101247

Granite Plains Mutual. Visit on Jul 26, 2026 with Jordan Blake, PA-C.

Paid as expected

Charged

$338.00

Contract expects

$166.38

Allowed per fee schedule

Payer allowed

$166.38

Payer paid

$66.38

Patient owes

$100.00

Deductible, coinsurance, copay

At stake

$0.00

What happened

Allowed at the contract rate. The payer paid $66.38 and $100.00 is the patient share.

Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999020544050.

No action needed

Paid correctly. The patient share goes on the next statement.

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	$153.40	$153.40	$53.40	$100.00	CO-45 Above the contracted rate $158.60 PR-1 Deductible $100.00
80053 Metabolic panel	$26.00	$12.98	$12.98	$12.98	$0.00	CO-45 Above the contracted rate $13.02

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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.

PR-1DeductiblePatient share

The amount the patient owes toward their annual deductible.

Patient responsibility: The patient owes this amount (deductible, coinsurance, copay or a non-covered service the patient agreed to).

Usual fix: Bill the patient for the deductible amount shown.

Every remittance that answered this claim, oldest first.

Paid	Payment	Result	Status	Paid
Aug 18, 2026	GP99900000544	Paid as expected	Current	$66.38

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