EOB Analysis + Resolve
| Claim ID |
Date of Service |
Submission Date |
CPT Code(s) | Billed Amount | Paid Amount | Patient Responsibility |
Denial Reason Code |
Rejection Code |
Customer | Actions |
|---|---|---|---|---|---|---|---|---|---|---|
| Y021MPE87127 | 1/16/2025 | 2/18/2025 | 63650/51 | $18,328.00 | $0.00 | $0.00 | Nl|CO 16|M51 | SisFirst | ||
| Y021MPE87127 | 1/16/2025 | 2/18/2025 | 63650 | $18,328.00 | $0.00 | $0.00 | DZ|CO 198|N54 | SisFirst | ||
| Y021MPE87127 | 1/16/2025 | 2/18/2025 | 63685 | $62,916.00 | $0.00 | $0.00 | Nk|CO 96|N351 | SisFirst | ||
| 1024318615700 | 11/5/2024 | 11/25/2024 | C9290 | $240.90 | $187.57 | $47.85 | SisFirst | |||
| 1024318615700 | 11/5/2024 | 11/25/2024 | 76942 TCXS | $1,000.00 | $0.00 | $0.00 | SisFirst | |||
| 1024318615700 | 11/5/2024 | 11/25/2024 | 64450 XPRT51 | $1,000.00 | $17.27 | $4.41 | SisFirst | |||
| 1024318615700 | 11/5/2024 | 11/25/2024 | 64447 XPRT | $1,000.00 | $0.00 | $0.00 | SisFirst | |||
| 1024318615700 | 11/5/2024 | 11/25/2024 | 27447 RT | $42,865.00 | $6,610.47 | $1,686.34 | SisFirst | |||
| Q100001202460547 | 12/27/2024 | 01/06/2025 | 20680 | $7749.75 | $1196.95 | $169.54 | SisFirst | |||
| H100001201678147 | 12/19/2024 | 01/06/2025 | 29882 | $8929.98 | $0.00 | $0.00 | SisFirst | |||
| Q100001201438344 | 11/27/2024 | 01/06/2025 | 28313 | $8929.98 | $769.19 | $0.00 | SisFirst | |||
| Q100001201438344 | 11/27/2024 | 01/06/2025 | 28308 | $8929.98 | $769.26 | $0.00 | SisFirst | |||
| Q100001201438344 | 11/27/2024 | 01/06/2025 | 28308 | $8929.98 | $769.26 | $0.00 | SisFirst | |||
| Q100001201438344 | 11/27/2024 | 01/06/2025 | 28285 | $8929.98 | $769.26 | $0.00 | SisFirst | |||
| Q100001201438344 | 11/27/2024 | 01/06/2025 | 28285 | $8929.98 | $769.26 | $146.48 | SisFirst | |||
| Q100001201438344 | 11/27/2024 | 01/06/2025 | 28899 | $621.03 | $53.52 | $53.52 | SisFirst | |||
| 197211 | 5/7/2024 | 02/04/2025 | HC:G9500 | $0.01 | $0.00 | $0.00 | 246 | N620 | SisFirst | |
| 197211 | 5/7/2024 | 02/04/2025 | HC:64636:50 | $1,600.00 | $0.00 | $0.00 | 96 | N115 | SisFirst | |
| 197211 | 5/7/2024 | 02/04/2025 | HC:64635:50 | $1,800.00 | $0.00 | $0.00 | 96 | N115 | SisFirst | |
| 020243555006N010X00 | 12/11/2024 | 01/08/2025 | 0278 | $0.00 | $0.00 | $0.00 | 197 | SisFirst | ||
| 020243555006N010X00 | 12/11/2024 | 01/08/2025 | 0278 | $9,975.00 | $2,122.34 | $599.01 | 197 | SisFirst | ||
| 020243555006N010X00 | 12/11/2024 | 01/08/2025 | 0490 | $272.58 | $58.00 | $16.37 | 197 | SisFirst | ||
| 020243555006N010X00 | 12/11/2024 | 01/08/2025 | 0490 | $8,891.26 | $0.00 | $0.00 | 197 | SisFirst | ||
| 020243555006N010X00 | 12/11/2024 | 01/08/2025 | 0490 | $18,904.83 | $4,022.29 | $1,135.26 | 197 | SisFirst | ||
| X257MPEB2041 | 9/10/2024 | 01/28/2025 | 63685 | $62,916.00 | $0.00 | $0.00 | \"Precertification/notificatio... | SisFirst | ||
| X257MPEB2041 | 9/10/2024 | 01/28/2025 | 63685 | $62,916.00 | $0.00 | $0.00 | \"Precertification/authorizati... | SisFirst | ||
| ESFDF3VJY0002 | 9/25/2024 | 09/27/2024 | HC:G9500 | $0.01 | $0.00 | $0.00 | 97 | SisFirst | ||
| ESFDF3VJY0002 | 9/25/2024 | 09/27/2024 | HC:J3301 | $520.00 | $6.46 | $1.65 | SisFirst | |||
| ESFDF3VJY0002 | 9/25/2024 | 09/27/2024 | HC:62323 | $750.00 | $0.00 | $0.00 | 197 | SisFirst | ||
| 12884V26490 | 11/14/2024 | 12/20/2024 | 99214.25 | $618.00 | $0.00 | $0.00 | SisFirst | |||
| 12884V26490 | 11/14/2024 | 12/20/2024 | 94010 | $128.00 | $0.00 | $28.48 | SisFirst | |||
| 02024095508755V0X01 | 4/1/2024 | 09/10/2024 | 0278 | -$14,100.00 | -$2,186.01 | $936.86 | M26 | SisFirst | ||
| 02024095508755V0X01 | 4/1/2024 | 09/10/2024 | 0490 | -$1,784.00 | $0.00 | $0.00 | M26 | SisFirst | ||
| 02024095508755V0X01 | 4/1/2024 | 09/10/2024 | 0490 | -$61,314.54 | -$13,429.95 | $150.00 | M26 | SisFirst | ||
| 2924348224050 | 12/4/2024 | 12/26/2024 | 20985 | $1,783.00 | $0.00 | $0.00 | 97 | SisFirst | ||
| 2924348224050 | 12/4/2024 | 12/26/2024 | 23430 LT | $18,716.99 | $0.00 | $0.00 | B15 | SisFirst | ||
| 2924348224050 | 12/4/2024 | 12/26/2024 | 23472 LT | $79,500.00 | $10,763.91 | $2,745.90 | SisFirst | |||
| 219730 | 10/15/2024 | 10/17/2024 | HC:G9500 | $0.01 | $0.00 | $0.00 | SisFirst | |||
| 219730 | 10/15/2024 | 10/17/2024 | HC:J1010:JZ | $300.00 | $10.23 | $0.00 | SisFirst | |||
| 219730 | 10/15/2024 | 10/17/2024 | HC:62323 | $750.00 | $0.00 | $0.00 | M127 | SisFirst | ||
| E7JNGTRS30002 | 10/17/2024 | 11/02/2024 | C1778 | $1,500.00 | $0.00 | $0.00 | Not covered when performed wit... | SisFirst | ||
| E7JNGTRS30002 | 10/17/2024 | 11/02/2024 | C1820 | $54,000.00 | $0.00 | $0.00 | Not covered when performed wit... | SisFirst | ||
| E7JNGTRS30002 | 10/17/2024 | 11/02/2024 | 63663 | $8,821.35 | $0.00 | $0.00 | Not covered when performed wit... | SisFirst | ||
| E7JNGTRS30002 | 10/17/2024 | 11/02/2024 | 63685 | $68,521.11 | $18,532.09 | $0.00 | SisFirst | |||
| EX94730795 | 2/26/2025 | 03/07/2025 | 69706 | $22,411.40 | $0.00 | $0.00 | 96 | SisFirst | ||
| 83 | NANCY\" | 020242955024P700X00 | 10/22/2024 | $490.00 | $4,200.50 | $0.00 | \"The information furnished do... | SisFirst | ||
| 240509105910 | 4/25/2024 | 05/30/2024 | C1755 | $3,060.00 | $0.00 | $0.00 | CO-96 | SisFirst | ||
| 240509105910 | 4/25/2024 | 05/30/2024 | 62350 | $24,143.10 | $0.00 | $0.00 | CO-197 | SisFirst | ||
| 11626V26490 | 9/3/2024 | 10/11/2024 | 99205.25 | $1,064.00 | $0.00 | $0.00 | SisFirst | |||
| 820243340055995 | 11/4/2024 | 11/27/2024 | 0275T Q0 | $11,760.00 | $0.00 | $0.00 | 96 | SisFirst |