Claims

CLM-2026-0002

Approved

Sharing Need · Mar 18, 2026 · City General Hospital

Billed

$12,800.00

Allowed

$10,500.00

Approved

$10,500.00

Member Resp.

$0.00

Claim Details
Provider
City General Hospital
Service Date
Mar 18, 2026
Submitted
Mar 19, 2026
Auto-Adjudicated
No
Flags
high-dollarpre-existing
Member

Emily Chen

MBR-10003

Active
Diagnosis Codes
I10— Essential hypertension(Principal)R00.0— Tachycardia, unspecified
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