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Dr. Sarah Johnson, MD

Internal Medicine

MD

123 Medical Center Dr, Denver, CO 80202

(555) 555-5555

Enhanced Provider Data
Professional Services
Facility: Denver Family Medicine
Provider Type: Primary Care
Service Date
Jan 28, 2026
Claim ID
EOB-2024-001234
Provider NPI
1234567890
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. Medicare Coinsurance of $19.20 applies.

Cost Breakdown

Provider Charged:$285.00
Medicare Allowed:$261.00
Medicare Paid:$241.80
Medicare Coinsurance:$19.20
Your Responsibility:$19.20

Coverage Insights

Preventive Services Identified: Some services on this claim are exempt from deductible requirements, which is why you may see $0 deductible applied.
100% Medicare Coverage: Certain services on this claim are covered at 100% by Medicare with no patient responsibility.
Processing Details:
  • Preventive visit (G0438) allowed at 100% of fee schedule
  • Standard office visit (99213) subject to Part B deductible and coinsurance

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

AI Summary

This was a routine office visit with Dr. Sarah Johnson for a general adult medical examination. While the claim was processed and approved, our AI analysis identified a potential billing inconsistency. The visit was billed as a diagnostic office visit (99213) in addition to an annual wellness visit (G0438). Typically, if the primary purpose is preventive, the diagnostic code should not be applied unless a separate, significant medical issue was addressed. This has resulted in a $19.20 coinsurance charge that may be contestable.

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

Risk Flags

Overcharges
  • Potential unbundling of services (99213 with G0438)
Billing Errors
  • Modifier 25 missing or incorrectly applied
Fraud Indicators
No issues detected
Duplicate Services
No issues detected
Appeal Opportunities
  • High likelihood of success for appealing 99213 coinsurance
Non Covered Services
No issues detected

Insights

Claim Complexity
medium
Coverage Gaps Identified
  • Diagnostic services during wellness visits are subject to cost-sharing
Billing Accuracy Assessment
potential_error
Potential Savings Opportunities
  • Appeal coinsurance for code 99213 if no separate medical issue was treated

Tags

billing-error
Z00.00(ICD_10)AI Enhanced
Primary

General adult medical exam

Encounter for general adult medical examination without abnormal findings. This code is used for routine health check-ups where no specific complaint or illness is being addressed.

Specialty
Internal Medicine/Family Practice
Category
Preventive Care
Clinical Notes
Standard code for annual physicals and wellness visits. Should result in $0 cost sharing for Medicare beneficiaries.
Typical follow-up Care
Schedule next annual wellness visit in 12 months
Review screening results with provider

Present on admission: No

99213(HCPCS)AI Enhanced

Office/outpatient visit for the evaluation and management of an established patient

$76.80
Medicare Paid

Office visit, established patient, low-moderate complexity

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. Typically involves 20-29 minutes of total time.

Specialty
Primary Care
Category
Evaluation & Management
Service: Feb 2, 2026
Provider charged
$120.00
Medicare Allowed
$96.00
Medicare Paid
$76.80
Your responsibility
$19.20
G0438(HCPCS)AI Enhanced

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

$165.00
Medicare Paid

Annual wellness visit, initial

Annual wellness visit, including a personalized prevention plan of service (PPS), initial visit. This service is for patients who have been enrolled in Medicare Part B for more than 12 months.

Specialty
Primary Care
Category
Preventive
Service: Feb 2, 2026
Provider charged
$165.00
Medicare Allowed
$165.00
Medicare Paid
$165.00
Your responsibility
$0.00

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