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Claim 820220140511490

Status: Completed

JAMES M DRISKILL

Provider
Jeereddi, Praveena MD
Out of network Help
Date of service
Dec 28, 2021
Date paid
Jan 18, 2022
Processed date
Jan 17, 2022

Claim details

Description Total billed charges Amount Humana paid Your share Payment status
Annual wellness visit, with personalized prevention plan of service $325.00 $0.00 $0.00 Prepaid
Service date
Dec 28, 2021
Service code Help
G0439
Humana discounts
$0.00
Plan exclusion
$75.00
Benefit exclusions
$0.00
Deductible
$0.00
Copay
$0.00
Coinsurance
$0.00
Total billed charges $325.00
Amount Humana paid $0.00
Your share $0.00
Payment status Prepaid
$180.82 $0.00 $0.00 Prepaid
Total billed charges $180.82
Amount Humana paid $0.00
Your share $0.00
Payment status Prepaid
$10.66 $0.00 $0.00 Prepaid
Total billed charges $10.66
Amount Humana paid $0.00
Your share $0.00
Payment status Prepaid
$0.01 $0.00 $0.00 Prepaid
Total billed charges $0.01
Amount Humana paid $0.00
Your share $0.00
Payment status Prepaid
$0.01 $0.00 $0.00 Prepaid
Total billed charges $0.01
Amount Humana paid $0.00
Your share $0.00
Payment status Prepaid
$0.01 $0.00 $0.00 Prepaid
Total billed charges $0.01
Amount Humana paid $0.00
Your share $0.00
Payment status Prepaid

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