Overview
Cash collected, claims submitted, and payer balances.
Paid
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Denial rate
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UnitedHealthcare · Service date Aug 22, 2026 · Dr. Priya Nair
MRN MRN-PAT-GEN-229 · 65 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 22, 2026 | 73721 | — | E11.9 | 11 - Office | 1 | $1,400.00 | |
Allowed— Pri ins paym$0.00 Pri ins adj— Pat resp$0.00 Pat bal$0.00 Bal$1,400.00 | |||||||
| Date of service | Facility | Status | Billed |
|---|---|---|---|
| Aug 8, 2026 | Northstar Family Health - Main | Paid | $1,800.00 |
| Aug 18, 2026 | Northstar Family Health - Main | Awaiting info | $45.00 |
| Jul 1, 2026 | Northstar Family Health - Main | Submitted | $2,200.00 |
| Jul 27, 2026 | Northstar Family Health - Main | Paid | $400.00 |
| Jul 31, 2026 | Northstar Family Health - Main | Paid | $55.00 |
| Aug 5, 2026 | Northstar Family Health - Main | In intake | $230.00 |
| May 21, 2026 | Northstar Family Health - Main | In intake | $4,800.00 |