Claims
Billed
$3,800.00
Allowed
$3,200.00
Approved
$2,700.00
Member Resp.
$1,000.00
Claim Details
- Provider
- Sunridge Orthopedics
- Service Date
- Apr 2, 2026
- Submitted
- Apr 2, 2026
- Auto-Adjudicated
- Yes
Member
Diagnosis Codes
M23.20— Derangement of meniscus due to old tear(Principal)
Service Lines
| # | CPT | Description | Billed | Allowed | Approved | Member Resp. |
|---|---|---|---|---|---|---|
| 1 | 29881 | Knee arthroscopy with meniscectomy | $3,800.00 | $3,200.00 | $2,700.00 | $1,000.00 |
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