Overview
Cash collected, claims submitted, and payer balances.
Paid
Outstanding with payer
Denial rate
Submitted
Aging over 30 days
Avg days to payment
Book snapshot
Claims mix
Paid
Denied
In flight
Outstanding balance
Payer
Patient
Activity
Aetna · Service date Jun 14, 2026 · Dr. Hannah Cole
MRN MRN-PAT-GEN-104 · 49 yrs
No secondary insurance on file for this patient.
No non-insurance payers (foundations, grants, cash pay) are linked to this claim.
Credentialing status unavailable for this provider.
No referring or supervising providers are attached to this encounter.
No additional submission details (referral numbers, authorization numbers, accident information) on this claim.
Encounter-level place of service is the code on Box 24B of the CMS-1500. Per-line overrides appear in the Service lines table below.
| Date of service | CPT code | Modifiers | Diagnoses | Place of service | Qty | Billed | Details |
|---|---|---|---|---|---|---|---|
| Jun 14, 2026 | 99205 | — | R51.9 | 11 - Office | 1 | $400.00 | |
Allowed$264.00 Pri ins paym$118.80 Pri ins adj$136.00 Pat resp$26.40 Pat bal$26.40 Bal$145.20 | |||||||
| Check date | Check number | ERA ID |
|---|---|---|
| Jun 26, 2026 | W-520608 | era-20608 |
| Check date | Check number | Payer Claim ID |
|---|---|---|
| Jun 26, 2026 | W-520608 | — |
| Date of service | Facility | Status | Billed |
|---|---|---|---|
| Aug 1, 2026 | Northstar Family Health - Main | Paid | $1,400.00 |
| Aug 1, 2026 | Northstar Family Health - Main | Paid | $1,400.00 |
| Aug 2, 2026 | Northstar Family Health - Main | Paid | $420.00 |
| Aug 17, 2026 | Northstar Family Health - Main | Submitted | $220.00 |
| Aug 3, 2026 | Northstar Family Health - Main | In intake | $230.00 |
| Jul 29, 2026 | Northstar Family Health - Main | Paid | $650.00 |
| Jul 29, 2026 | Northstar Family Health - Main | Paid | $320.00 |
| Jul 25, 2026 | Northstar Family Health - Main | Paid | $220.00 |