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 Aug 3, 2026 · Dr. Samuel Ortiz
MRN MRN-PAT-GEN-236 · 38 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 3, 2026 | 71046 | — | I10 | 11 - Office | 1 | $220.00 | |
Allowed$145.20 Pri ins paym$130.68 Pri ins adj$74.80 Pat resp$14.52 Pat bal$14.52 Bal$14.52 | |||||||
| Check date | Check number | ERA ID |
|---|---|---|
| Aug 15, 2026 | W-521388 | era-21388 |
| Check date | Check number | Payer Claim ID |
|---|---|---|
| Aug 15, 2026 | W-521388 | — |
| Date of service | Facility | Status | Billed |
|---|---|---|---|
| Aug 20, 2026 | Northstar Family Health - Main | Paid | $1,400.00 |
| Jul 28, 2026 | Northstar Family Health - Main | Submitted | $650.00 |
| Aug 22, 2026 | Northstar Family Health - Main | Awaiting info | $230.00 |
| Jul 17, 2026 | Northstar Family Health - Main | ERA received | $400.00 |
| Jul 29, 2026 | Northstar Family Health - Main | Paid | $240.00 |
| Jun 5, 2026 | Northstar Family Health - Main | Waiting on provider | $55.00 |
| Aug 24, 2026 | Northstar Family Health - Main | Not billable | $2,200.00 |