Overview
Cash collected, claims submitted, and payer balances.
Paid
Outstanding with payer
Denial rate
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Aging over 30 days
Avg days to payment
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Activity
UnitedHealthcare · Service date Aug 8, 2026 · Dr. Lena Whitfield
MRN MRN-PAT-GEN-192 · 22 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 |
|---|---|---|---|---|---|---|---|
| Aug 8, 2026 | 99215 | — | M54.50 | 11 - Office | 1 | $320.00 | |
Allowed$211.20 Pri ins paym$190.08 Pri ins adj$108.80 Pat resp$21.12 Pat bal$21.12 Bal$21.12 | |||||||
| Check date | Check number | ERA ID |
|---|---|---|
| Aug 20, 2026 | UHC-521113 | era-21113 |
| Check date | Check number | Payer Claim ID |
|---|---|---|
| Aug 20, 2026 | UHC-521113 | — |
| Date of service | Facility | Status | Billed |
|---|---|---|---|
| May 24, 2026 | Northstar Family Health - Main | Awaiting info | $420.00 |
| Aug 1, 2026 | Northstar Family Health - Main | ERA received | $1,800.00 |
| Jul 28, 2026 | Northstar Family Health - Main | Paid | $300.00 |
| Jul 29, 2026 | Northstar Family Health - Main | Paid | $230.00 |
| Aug 14, 2026 | Northstar Family Health - Main | Paid | $300.00 |