| Claim Number | Patient | Service Date | Payer | Provider | Claim Amount | Balance | Status | Denial Reason | Days Out | Action |
|---|---|---|---|---|---|---|---|---|---|---|
| CLM-2024-002891 | Jennifer Lee PT-12389 | 2024-01-28 | Aetna | Dr. David Park | $8,900.00 | $8,900.00 | denied | Missing Information CO-16 | 38 | |
| CLM-2024-004123 | Amanda Davis PT-23456 | 2024-01-20 | Humana | Dr. James Wilson | $5,600.00 | $5,600.00 | denied | Timely Filing Limit CO-29 | 52 | |
| CLM-2024-006234 | Jessica Miller PT-34567 | 2024-01-25 | Blue Cross Blue Shield | Dr. Robert Taylor | $12,500.00 | $12,500.00 | denied | Non-Covered Service CO-96 | 42 |