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Northwest Community Hospital

General Acute Care Hospital

Facility

800 W Central Rd, Arlington Heights, IL 60005

(847) 618-1000

Enhanced Provider Data
Outpatient
Facility Type: General Hospital
Facility: Northwest Community Hospital
Provider Type: Hospital
Service Date
Dec 29, 2025
Claim ID
EOB-2024-001189
Provider NPI
9876543210
Status
Approved

Financial Breakdown

Coverage Details

Covered Service
Part B
No Deductible Required

This service is covered under your insurance plan. No deductible was applied to this claim.

Cost Breakdown

Provider Charged:$215.00
Medicare Allowed:$215.00
Medicare Paid:$215.00
Your Responsibility:$0.00

Coverage Insights

100% Medicare Coverage: Certain services on this claim are covered at 100% by Medicare with no patient responsibility.
Processing Details:
  • Lab services fully covered under Part B clinical laboratory benefit
  • No deductible or coinsurance applied for these tests

💡 These insights are derived from Medicare's adjudication data to help explain your coverage details.

AI Summary

Comprehensive outpatient diagnostic workup including metabolic panel and thyroid function tests. All services were fully covered by Medicare with no patient responsibility.

AI analysis is for informational purposes only and should not replace professional medical or financial advice.

Risk Flags

Overcharges
No issues detected
Billing Errors
No issues detected
Fraud Indicators
No issues detected
Duplicate Services
No issues detected
Appeal Opportunities
No issues detected
Non Covered Services
No issues detected

Insights

Claim Complexity
low
Coverage Gaps Identified
Billing Accuracy Assessment
accurate
Potential Savings Opportunities
R07.9(ICD_10)AI Enhanced
Primary

Chest pain, unspecified

Unspecified chest pain. This diagnosis is often used when a patient presents with chest pain but a specific cause (like heart attack or infection) has not yet been determined or ruled out.

Specialty
General Practice
Category
Symptoms
Clinical Notes
This code indicates you sought care for chest pain, and the specific cause was not immediately diagnosed or was ruled out as cardiac in origin at this visit. It justifies the ordered lab tests.
Typical follow-up Care
Monitor for worsening symptoms
Follow up with primary care if pain persists

Present on admission: No

E03.9(ICD_10)AI Enhanced
Secondary

Hypothyroidism, unspecified

Hypothyroidism, unspecified. A condition where the thyroid gland does not produce enough thyroid hormone, regulating metabolism.

Specialty
Endocrinology
Category
Endocrine
Clinical Notes
A chronic condition requiring regular monitoring of thyroid hormone levels (TSH, T4) to adjust medication dosage.
Typical follow-up Care
Annual thyroid panel

Present on admission: No

84295(CPT)AI Enhanced

Sodium

$60.00
Medicare Paid

Blood test for Sodium

Assay of serum sodium. This test measures the concentration of sodium in your blood, an electrolyte vital for normal muscle and nerve function.

Specialty
Clinical Laboratory
Category
Laboratory/Pathology
Service: Dec 29, 2025
Provider charged
$60.00
Medicare Allowed
$60.00
Medicare Paid
$60.00
Your responsibility
$0.00
84436(CPT)AI Enhanced

Thyroxine (T4)

$155.00
Medicare Paid

Blood test for Thyroxine (T4)

Assay of total thyroxine. Measures the level of T4, the main hormone produced by your thyroid gland.

Specialty
Endocrinology
Category
Laboratory/Pathology
Service: Dec 29, 2025
Provider charged
$155.00
Medicare Allowed
$155.00
Medicare Paid
$155.00
Your responsibility
$0.00

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