Contractual recovery
Class 2 — systematic underpayment by payer × code (not individually appealable) · for provider-relations recovery
Recoverable — systematic
$1,801,543
7,298 claim(s)
Recovery cases
194
payer × code relationships
Payers
8
with a systematic shortfall
Recovery cases — largest first
| Payer | CPT | Claims |
Paid % of contract | Recoverable | Period |
| Calidon Health Plan |
27447 |
285 |
85.7% |
$167,406.32 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
27447 |
216 |
83.5% |
$141,963.51 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
29881 |
317 |
85.5% |
$117,379.32 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
47562 |
275 |
85.6% |
$117,111.65 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
47562 |
222 |
83.3% |
$106,544.42 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
27447 |
181 |
85.6% |
$100,921.43 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
29881 |
223 |
83.4% |
$91,155.90 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
49505 |
236 |
83.3% |
$74,757.86 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
49505 |
257 |
85.4% |
$72,910.88 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
19120 |
265 |
85.5% |
$60,074.43 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
66984 |
294 |
85.6% |
$59,291.75 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
19120 |
219 |
83.4% |
$55,315.15 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
27447 |
139 |
89.9% |
$52,909.73 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
27447 |
90 |
85.8% |
$46,536.49 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
47562 |
113 |
85.6% |
$45,777.75 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
29881 |
124 |
85.7% |
$42,999.63 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
66984 |
185 |
83.5% |
$41,457.20 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
45378 |
246 |
85.7% |
$34,231.12 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
72148 |
294 |
85.7% |
$32,371.19 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
47562 |
87 |
86.0% |
$32,264.12 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
73721 |
271 |
85.6% |
$28,213.60 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
47562 |
89 |
90.1% |
$24,181.59 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
43239 |
200 |
85.6% |
$23,483.43 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
29881 |
63 |
85.5% |
$20,942.24 |
Jan 2026 – Aug 2026
|
| Westmark Health Plan |
49505 |
67 |
85.6% |
$17,911.65 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
29881 |
70 |
90.0% |
$16,677.42 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
74177 |
185 |
85.6% |
$16,508.21 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
45378 |
97 |
83.3% |
$15,504.86 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
64483 |
114 |
85.6% |
$10,083.81 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
49505 |
35 |
85.6% |
$8,815.03 |
Jan 2026 – Sep 2026
|
| Medicaid |
27447 |
32 |
89.9% |
$8,667.14 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
66984 |
42 |
86.1% |
$7,431.83 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
19120 |
37 |
85.7% |
$7,419.36 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
19120 |
28 |
85.8% |
$5,952.64 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
99205 |
128 |
82.2% |
$5,399.30 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
43239 |
41 |
83.4% |
$5,385.52 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
99223 |
116 |
81.6% |
$5,224.21 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
99285 |
88 |
82.3% |
$5,150.24 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
72148 |
51 |
85.6% |
$5,041.14 |
Jan 2026 – Sep 2026
|
| Vantegra Health Plan |
72148 |
39 |
82.8% |
$4,939.48 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
99285 |
104 |
85.5% |
$4,701.91 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
45378 |
35 |
85.4% |
$4,473.51 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
43239 |
38 |
85.5% |
$4,051.81 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
73721 |
42 |
85.4% |
$3,948.56 |
Feb 2026 – Aug 2026
|
| Calidon Health Plan |
93306 |
53 |
85.3% |
$3,771.02 |
Jan 2026 – Sep 2026
|
| Medicaid |
47562 |
18 |
89.7% |
$3,535.53 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
71250 |
61 |
85.5% |
$3,439.04 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
74177 |
43 |
85.4% |
$3,403.34 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
64483 |
36 |
85.9% |
$2,823.51 |
Jan 2026 – Aug 2026
|
| Corion Health Plan |
93306 |
44 |
85.7% |
$2,800.99 |
Jan 2026 – Sep 2026
|
| Tricare |
27447 |
8 |
90.4% |
$2,546.25 |
Jan 2026 – Jul 2026
|
| Pinehaven Health Plan |
49505 |
13 |
90.2% |
$2,339.28 |
Mar 2026 – Sep 2026
|
| Corion Health Plan |
70450 |
53 |
85.5% |
$2,331.28 |
Jan 2026 – Sep 2026
|
| Corion Health Plan |
62323 |
37 |
85.5% |
$2,327.61 |
Jan 2026 – Sep 2026
|
| Calidon Health Plan |
62323 |
29 |
85.9% |
$2,021.21 |
Jan 2026 – Sep 2026
|
| Tricare |
47562 |
9 |
90.1% |
$2,014.08 |
Jan 2026 – Jul 2026
|
| Medicaid |
29881 |
12 |
89.7% |
$2,009.53 |
Jan 2026 – Jul 2026
|
| Tricare |
29881 |
8 |
90.5% |
$1,559.26 |
Feb 2026 – Aug 2026
|
| Corion Health Plan |
99223 |
20 |
86.4% |
$664.63 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
99233 |
16 |
82.2% |
$641.98 |
Jan 2026 – Sep 2026
|
| Westmark Health Plan |
66984 |
3 |
85.7% |
$589.96 |
Feb 2026 – Apr 2026
|
| Pinehaven Health Plan |
66984 |
4 |
89.6% |
$508.30 |
Jan 2026 – Aug 2026
|
| Pinehaven Health Plan |
74177 |
8 |
90.3% |
$440.58 |
Jan 2026 – Jul 2026
|
| Pinehaven Health Plan |
99285 |
13 |
90.1% |
$408.95 |
Feb 2026 – Sep 2026
|
| Pinehaven Health Plan |
64483 |
6 |
89.7% |
$361.57 |
Jan 2026 – Jul 2026
|
| Pinehaven Health Plan |
99284 |
16 |
90.2% |
$346.08 |
Feb 2026 – Aug 2026
|
| Pinehaven Health Plan |
19120 |
2 |
89.0% |
$315.03 |
Mar 2026 – May 2026
|
| Pinehaven Health Plan |
99204 |
16 |
90.0% |
$300.42 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
73721 |
4 |
90.0% |
$269.75 |
May 2026 – Sep 2026
|
| Pinehaven Health Plan |
99233 |
11 |
89.8% |
$249.36 |
Feb 2026 – Sep 2026
|
| Pinehaven Health Plan |
62323 |
5 |
89.3% |
$240.54 |
Mar 2026 – Jul 2026
|
| Pinehaven Health Plan |
99215 |
12 |
90.5% |
$237.60 |
Jan 2026 – Jul 2026
|
| Pinehaven Health Plan |
93306 |
5 |
90.3% |
$226.59 |
Mar 2026 – Jun 2026
|
| Pinehaven Health Plan |
70450 |
7 |
90.3% |
$211.70 |
Feb 2026 – Jul 2026
|
| Pinehaven Health Plan |
99283 |
16 |
90.2% |
$206.96 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
99232 |
12 |
89.8% |
$192.63 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
99223 |
8 |
89.8% |
$191.32 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
99203 |
16 |
90.5% |
$186.48 |
Feb 2026 – Aug 2026
|
| Pinehaven Health Plan |
77067 |
12 |
90.3% |
$186.21 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
45378 |
2 |
90.5% |
$174.68 |
Jan 2026
|
| Pinehaven Health Plan |
99221 |
15 |
90.2% |
$174.20 |
Jan 2026 – Sep 2026
|
| Pinehaven Health Plan |
99213 |
18 |
90.7% |
$172.07 |
Feb 2026 – Sep 2026
|
| Pinehaven Health Plan |
76700 |
8 |
90.2% |
$171.18 |
Mar 2026 – Jul 2026
|
| Pinehaven Health Plan |
99205 |
7 |
89.9% |
$162.19 |
Feb 2026 – Aug 2026
|
| Pinehaven Health Plan |
99214 |
10 |
89.9% |
$144.80 |
Jan 2026 – Aug 2026
|
| Medicaid |
49505 |
1 |
90.0% |
$132.80 |
Jul 2026
|
| Pinehaven Health Plan |
71250 |
3 |
88.9% |
$129.55 |
Feb 2026 – Jul 2026
|
| Pinehaven Health Plan |
72148 |
2 |
90.0% |
$129.11 |
Aug 2026 – Sep 2026
|
| Pinehaven Health Plan |
99202 |
15 |
89.6% |
$127.10 |
Jan 2026 – Aug 2026
|
| Pinehaven Health Plan |
99222 |
7 |
89.5% |
$118.94 |
Jan 2026 – Jul 2026
|
| Tricare |
66984 |
1 |
89.4% |
$115.51 |
Feb 2026
|
| Pinehaven Health Plan |
10060 |
7 |
90.2% |
$107.89 |
Jan 2026 – Jul 2026
|
| Medicare |
29881 |
1 |
94.9% |
$107.50 |
Jul 2026
|
| Pinehaven Health Plan |
90834 |
9 |
89.6% |
$105.99 |
Jan 2026 – Jun 2026
|
| Pinehaven Health Plan |
99231 |
11 |
89.8% |
$96.33 |
Jan 2026 – Aug 2026
|
| Medicaid |
19120 |
1 |
91.4% |
$95.26 |
Mar 2026
|
| Medicaid |
66984 |
1 |
89.1% |
$90.34 |
Jul 2026
|
| Pinehaven Health Plan |
99212 |
12 |
90.7% |
$73.10 |
Feb 2026 – Sep 2026
|
| Pinehaven Health Plan |
43239 |
1 |
90.9% |
$72.40 |
Feb 2026
|
| Medicaid |
45378 |
1 |
88.9% |
$72.18 |
May 2026
|
| Medicare |
72148 |
2 |
93.9% |
$64.50 |
Apr 2026 – May 2026
|
| Pinehaven Health Plan |
84443 |
16 |
89.9% |
$62.78 |
Mar 2026 – Aug 2026
|
| Tricare |
43239 |
1 |
89.5% |
$61.39 |
Sep 2026
|
| Pinehaven Health Plan |
80061 |
16 |
90.1% |
$53.53 |
Jan 2026 – Aug 2026
|
| Medicaid |
72148 |
1 |
90.0% |
$53.41 |
Aug 2026
|
| Medicaid |
99285 |
2 |
89.3% |
$48.30 |
Feb 2026 – Jul 2026
|
| Medicaid |
77067 |
4 |
89.3% |
$47.62 |
Feb 2026 – May 2026
|
| Tricare |
93306 |
1 |
87.4% |
$43.02 |
Jan 2026
|
| Medicaid |
73721 |
1 |
90.7% |
$41.96 |
Jan 2026
|
| Tricare |
99205 |
2 |
89.3% |
$38.71 |
May 2026 – Jul 2026
|
| Medicaid |
99204 |
3 |
90.7% |
$37.23 |
May 2026 – Aug 2026
|
| Pinehaven Health Plan |
99211 |
13 |
89.3% |
$36.47 |
Jan 2026 – Aug 2026
|
| Medicare |
43239 |
1 |
94.6% |
$34.50 |
Aug 2026
|
| Medicaid |
62323 |
1 |
89.6% |
$33.85 |
Jun 2026
|
| Medicaid |
93306 |
1 |
89.4% |
$32.86 |
Mar 2026
|
| Pinehaven Health Plan |
87070 |
9 |
89.9% |
$32.22 |
Jan 2026 – Sep 2026
|
| Medicaid |
99233 |
2 |
90.1% |
$30.74 |
Jan 2026 – Aug 2026
|
| Tricare |
99285 |
1 |
87.7% |
$30.03 |
Jan 2026
|
| Medicare |
99285 |
2 |
94.6% |
$29.50 |
Apr 2026 – May 2026
|
| Pinehaven Health Plan |
97110 |
6 |
90.3% |
$28.56 |
Feb 2026 – Jun 2026
|
| Pinehaven Health Plan |
93000 |
9 |
90.2% |
$27.23 |
Jan 2026 – Aug 2026
|
| Pinehaven Health Plan |
96372 |
8 |
90.3% |
$25.13 |
Jan 2026 – Sep 2026
|
| Medicaid |
71250 |
1 |
90.9% |
$24.46 |
Apr 2026
|
| Medicaid |
70450 |
1 |
88.2% |
$24.29 |
Feb 2026
|
| Medicaid |
90834 |
3 |
90.9% |
$23.11 |
Jan 2026 – Apr 2026
|
| Tricare |
99283 |
2 |
89.8% |
$22.59 |
Mar 2026 – Sep 2026
|
| Medicaid |
99232 |
2 |
90.0% |
$22.35 |
Jan 2026 – Apr 2026
|
| Pinehaven Health Plan |
80053 |
9 |
89.8% |
$22.16 |
Feb 2026 – Aug 2026
|
| Medicare |
99232 |
3 |
94.3% |
$21.30 |
Jan 2026 – Sep 2026
|
| Tricare |
99233 |
1 |
87.6% |
$20.99 |
Mar 2026
|
| Tricare |
99223 |
1 |
89.1% |
$20.47 |
Mar 2026
|
| Medicaid |
99213 |
3 |
90.6% |
$20.28 |
Jan 2026 – Sep 2026
|
| Tricare |
99284 |
1 |
89.4% |
$19.88 |
Apr 2026
|
| Tricare |
76700 |
1 |
88.1% |
$19.63 |
Feb 2026
|
| Medicare |
76700 |
2 |
94.6% |
$19.50 |
Feb 2026 – Apr 2026
|
| Pinehaven Health Plan |
85025 |
10 |
90.3% |
$19.40 |
Jan 2026 – Jul 2026
|
| Medicare |
99203 |
3 |
94.5% |
$16.50 |
Mar 2026 – Sep 2026
|
| Medicaid |
99223 |
1 |
90.2% |
$15.55 |
Mar 2026
|
| Medicaid |
99205 |
1 |
90.1% |
$14.92 |
May 2026
|
| Pinehaven Health Plan |
81001 |
10 |
89.6% |
$13.84 |
Jan 2026 – Aug 2026
|
| Medicaid |
76700 |
1 |
91.4% |
$13.52 |
Apr 2026
|
| Tricare |
99214 |
1 |
89.2% |
$13.26 |
Sep 2026
|
| Tricare |
99232 |
1 |
89.4% |
$13.11 |
Jul 2026
|
| Tricare |
10060 |
1 |
90.7% |
$13.06 |
May 2026
|
| Medicaid |
20610 |
2 |
90.7% |
$13.04 |
Aug 2026
|
| Pinehaven Health Plan |
83036 |
5 |
90.5% |
$13.04 |
Jan 2026 – Jun 2026
|
| Medicaid |
99215 |
1 |
91.4% |
$12.25 |
Jan 2026
|
| Medicare |
99221 |
2 |
94.9% |
$11.00 |
May 2026 – Sep 2026
|
| Medicare |
99233 |
1 |
94.3% |
$10.20 |
Jul 2026
|
| Tricare |
99203 |
1 |
90.5% |
$9.34 |
Jan 2026
|
| Medicaid |
99214 |
1 |
89.9% |
$9.32 |
Mar 2026
|
| Medicare |
97110 |
4 |
94.5% |
$9.00 |
Feb 2026 – Aug 2026
|
| Medicaid |
99212 |
2 |
89.7% |
$8.95 |
Feb 2026 – Mar 2026
|
| Medicaid |
99283 |
1 |
90.9% |
$8.81 |
Jan 2026
|
| Medicaid |
99221 |
1 |
90.3% |
$8.57 |
Aug 2026
|
| Tricare |
90834 |
1 |
90.6% |
$8.55 |
Jul 2026
|
| Tricare |
99213 |
1 |
90.7% |
$8.13 |
Jul 2026
|
| Medicaid |
87070 |
3 |
90.1% |
$7.62 |
Jan 2026 – Aug 2026
|
| Medicaid |
97110 |
2 |
88.9% |
$7.51 |
Mar 2026 – Aug 2026
|
| Medicaid |
99211 |
4 |
89.7% |
$7.44 |
Feb 2026 – Sep 2026
|
| Medicare |
77067 |
1 |
93.8% |
$7.25 |
May 2026
|
| Tricare |
99211 |
3 |
89.6% |
$6.98 |
Feb 2026 – Mar 2026
|
| Tricare |
99231 |
1 |
91.6% |
$6.25 |
Mar 2026
|
| Pinehaven Health Plan |
80048 |
3 |
89.2% |
$6.19 |
Mar 2026 – Jul 2026
|
| Medicaid |
84443 |
2 |
88.8% |
$5.91 |
Jan 2026 – Jul 2026
|
| Medicare |
99212 |
2 |
94.2% |
$5.70 |
Apr 2026 – May 2026
|
| Medicaid |
99202 |
1 |
90.2% |
$5.28 |
Aug 2026
|
| Medicare |
90834 |
1 |
94.8% |
$5.25 |
Jul 2026
|
| Medicaid |
80061 |
2 |
89.9% |
$4.62 |
Jul 2026
|
| Medicare |
99213 |
1 |
94.5% |
$4.60 |
Mar 2026
|
| Tricare |
80053 |
2 |
88.5% |
$4.38 |
Feb 2026 – May 2026
|
| Tricare |
83036 |
2 |
89.3% |
$4.22 |
Apr 2026 – Jul 2026
|
| Medicaid |
85025 |
3 |
89.7% |
$4.09 |
Mar 2026 – Jul 2026
|
| Medicare |
99231 |
1 |
94.1% |
$3.90 |
Jan 2026
|
| Tricare |
97110 |
1 |
90.7% |
$3.89 |
Jun 2026
|
| Medicare |
99211 |
3 |
94.6% |
$3.60 |
Jan 2026 – Sep 2026
|
| Medicaid |
80053 |
2 |
89.6% |
$3.59 |
Feb 2026 – Aug 2026
|
| Medicaid |
83036 |
2 |
90.4% |
$3.56 |
Jun 2026 – Aug 2026
|
| Tricare |
80048 |
2 |
90.0% |
$3.27 |
Mar 2026 – Sep 2026
|
| Medicaid |
81001 |
3 |
90.0% |
$2.84 |
Jan 2026 – Jun 2026
|
| Medicare |
93000 |
2 |
94.7% |
$2.80 |
Apr 2026 – Jul 2026
|
| Tricare |
80061 |
1 |
89.0% |
$2.79 |
Feb 2026
|
| Tricare |
84443 |
1 |
91.7% |
$2.78 |
Jan 2026
|
| Medicaid |
80048 |
2 |
90.3% |
$2.63 |
May 2026 – Aug 2026
|
| Tricare |
96372 |
1 |
92.0% |
$2.39 |
Jan 2026
|
| Medicaid |
96372 |
1 |
92.2% |
$2.00 |
Feb 2026
|
| Tricare |
85025 |
1 |
87.8% |
$1.87 |
Aug 2026
|
| Medicare |
85025 |
2 |
94.8% |
$1.80 |
May 2026 – Jun 2026
|
| Medicare |
87070 |
1 |
93.9% |
$1.60 |
Jan 2026
|
| Medicare |
80061 |
1 |
94.7% |
$1.50 |
Apr 2026
|
| Medicare |
96372 |
1 |
94.3% |
$1.50 |
Aug 2026
|
| Medicare |
81001 |
2 |
94.8% |
$1.20 |
Jan 2026 – Apr 2026
|
| Medicare |
83036 |
1 |
94.9% |
$1.20 |
Apr 2026
|
| Tricare |
81001 |
1 |
91.9% |
$0.97 |
Aug 2026
|