You're viewing a demo with synthetic data for Calderwood Health System. See this on your own claims →

Contractual recovery

Class 2 — systematic underpayment by payer × code (not individually appealable) · for provider-relations recovery
Recoverable — systematic
$3,841,359
15,597 claim(s)
Recovery cases
231
payer × code relationships
Payers
8
with a systematic shortfall

Recovery cases — largest first

PayerCPTClaims Paid % of contractRecoverablePeriod
Calidon Health Plan 27447 617 85.6% $365,115.32 Jan 2025 – Sep 2026
Vantegra Health Plan 27447 455 83.4% $301,005.41 Jan 2025 – Sep 2026
Calidon Health Plan 47562 593 85.6% $252,845.52 Jan 2025 – Sep 2026
Calidon Health Plan 29881 635 85.5% $234,560.09 Jan 2025 – Sep 2026
Vantegra Health Plan 47562 478 83.4% $227,651.95 Jan 2025 – Sep 2026
Westmark Health Plan 27447 352 85.6% $197,187.03 Jan 2025 – Sep 2026
Vantegra Health Plan 29881 478 83.4% $196,072.81 Jan 2025 – Sep 2026
Calidon Health Plan 49505 584 85.5% $165,331.08 Jan 2025 – Sep 2026
Vantegra Health Plan 49505 506 83.3% $160,542.63 Jan 2025 – Sep 2026
Calidon Health Plan 19120 574 85.5% $129,752.78 Jan 2025 – Sep 2026
Calidon Health Plan 66984 611 85.6% $123,985.20 Jan 2025 – Sep 2026
Pinehaven Health Plan 27447 307 89.9% $117,060.40 Jan 2025 – Sep 2026
Vantegra Health Plan 19120 455 83.4% $114,895.66 Jan 2025 – Sep 2026
Westmark Health Plan 47562 269 85.5% $108,916.36 Jan 2025 – Sep 2026
Corion Health Plan 27447 182 85.7% $95,064.13 Jan 2025 – Sep 2026
Vantegra Health Plan 66984 414 83.3% $93,592.90 Jan 2025 – Sep 2026
Westmark Health Plan 29881 245 85.6% $85,344.61 Jan 2025 – Sep 2026
Calidon Health Plan 45378 529 85.7% $73,882.12 Jan 2025 – Sep 2026
Calidon Health Plan 72148 638 85.6% $70,413.57 Jan 2025 – Sep 2026
Corion Health Plan 47562 174 85.7% $65,795.42 Jan 2025 – Sep 2026
Calidon Health Plan 73721 549 85.5% $57,546.29 Jan 2025 – Sep 2026
Pinehaven Health Plan 47562 192 90.0% $52,572.68 Jan 2025 – Sep 2026
Calidon Health Plan 43239 421 85.5% $49,778.76 Jan 2025 – Sep 2026
Corion Health Plan 29881 136 85.6% $45,036.80 Jan 2025 – Aug 2026
Westmark Health Plan 49505 153 85.6% $40,898.32 Jan 2025 – Sep 2026
Calidon Health Plan 74177 424 85.5% $37,905.45 Jan 2025 – Sep 2026
Pinehaven Health Plan 29881 155 89.9% $36,940.26 Jan 2025 – Sep 2026
Vantegra Health Plan 45378 208 83.3% $33,192.55 Jan 2025 – Sep 2026
Calidon Health Plan 64483 242 85.5% $21,504.08 Jan 2025 – Sep 2026
Corion Health Plan 49505 78 85.7% $19,699.57 Jan 2025 – Sep 2026
Corion Health Plan 66984 99 85.7% $17,858.82 Jan 2025 – Sep 2026
Medicaid 27447 65 89.9% $17,490.99 Jan 2025 – Sep 2026
Corion Health Plan 19120 85 85.6% $17,237.87 Jan 2025 – Sep 2026
Vantegra Health Plan 43239 93 83.3% $12,237.83 Jan 2025 – Sep 2026
Westmark Health Plan 19120 55 85.8% $11,633.03 Jan 2025 – Sep 2026
Westmark Health Plan 99285 196 82.2% $11,521.03 Jan 2025 – Sep 2026
Corion Health Plan 72148 112 85.5% $11,127.13 Jan 2025 – Sep 2026
Westmark Health Plan 99223 238 81.9% $10,619.12 Jan 2025 – Sep 2026
Westmark Health Plan 99205 250 82.2% $10,543.62 Jan 2025 – Sep 2026
Corion Health Plan 99285 231 85.6% $10,441.88 Jan 2025 – Sep 2026
Corion Health Plan 73721 100 85.6% $9,346.36 Jan 2025 – Aug 2026
Corion Health Plan 45378 71 85.5% $8,976.04 Jan 2025 – Sep 2026
Vantegra Health Plan 72148 69 82.7% $8,783.34 Jan 2025 – Sep 2026
Corion Health Plan 74177 103 85.2% $8,224.82 Jan 2025 – Sep 2026
Corion Health Plan 43239 76 85.6% $8,076.40 Jan 2025 – Sep 2026
Calidon Health Plan 93306 112 85.3% $7,987.86 Jan 2025 – Sep 2026
Corion Health Plan 71250 119 85.4% $6,682.30 Jan 2025 – Sep 2026
Tricare 27447 20 90.1% $6,395.22 Jan 2025 – Jul 2026
Medicaid 47562 32 90.0% $6,213.67 Jan 2025 – Sep 2026
Corion Health Plan 64483 76 85.7% $6,011.23 Jan 2025 – Aug 2026
Corion Health Plan 93306 88 85.7% $5,607.05 Jan 2025 – Sep 2026
Calidon Health Plan 62323 73 85.8% $5,102.38 Jan 2025 – Sep 2026
Corion Health Plan 62323 76 85.7% $4,794.68 Jan 2025 – Sep 2026
Corion Health Plan 70450 104 85.4% $4,571.59 Jan 2025 – Sep 2026
Pinehaven Health Plan 49505 24 90.2% $4,358.72 Feb 2025 – Sep 2026
Tricare 47562 18 89.8% $4,136.80 Mar 2025 – Jul 2026
Medicaid 29881 18 89.9% $3,009.13 Apr 2025 – Jul 2026
Tricare 29881 13 90.4% $2,518.10 Jun 2025 – Aug 2026
Westmark Health Plan 99233 37 82.3% $1,479.80 Jan 2025 – Sep 2026
Corion Health Plan 99223 44 86.0% $1,476.96 Jan 2025 – Sep 2026
Westmark Health Plan 66984 6 85.3% $1,187.41 Jan 2025 – Apr 2026
Pinehaven Health Plan 99285 34 89.9% $1,095.83 Jan 2025 – Sep 2026
Pinehaven Health Plan 73721 16 90.0% $1,078.93 Feb 2025 – Sep 2026
Pinehaven Health Plan 66984 7 89.7% $899.75 Aug 2025 – Aug 2026
Pinehaven Health Plan 74177 15 89.7% $860.54 Jan 2025 – Jul 2026
Pinehaven Health Plan 19120 5 89.3% $760.76 Jul 2025 – May 2026
Pinehaven Health Plan 99233 26 90.0% $588.90 Jan 2025 – Sep 2026
Pinehaven Health Plan 99284 25 90.2% $546.52 Mar 2025 – Aug 2026
Pinehaven Health Plan 99215 26 90.1% $527.89 Jan 2025 – Jul 2026
Pinehaven Health Plan 62323 11 89.4% $519.73 Apr 2025 – Jul 2026
Pinehaven Health Plan 43239 7 90.4% $515.41 May 2025 – Feb 2026
Pinehaven Health Plan 99204 27 89.9% $504.75 Mar 2025 – Sep 2026
Pinehaven Health Plan 70450 16 90.1% $498.26 Feb 2025 – Jul 2026
Pinehaven Health Plan 99223 19 89.6% $469.29 Jan 2025 – Sep 2026
Pinehaven Health Plan 99283 36 90.0% $466.67 Jan 2025 – Sep 2026
Pinehaven Health Plan 72148 7 90.5% $465.96 Apr 2025 – Sep 2026
Pinehaven Health Plan 45378 5 90.6% $443.14 May 2025 – Jan 2026
Pinehaven Health Plan 99232 26 89.9% $409.84 Feb 2025 – Sep 2026
Pinehaven Health Plan 93306 9 89.7% $409.43 Feb 2025 – Jun 2026
Pinehaven Health Plan 99203 34 90.2% $401.61 Jan 2025 – Aug 2026
Pinehaven Health Plan 99205 17 90.0% $398.90 Jan 2025 – Aug 2026
Pinehaven Health Plan 99213 39 90.1% $386.99 Feb 2025 – Sep 2026
Pinehaven Health Plan 99214 26 90.1% $370.17 Feb 2025 – Aug 2026
Medicaid 49505 3 90.6% $369.69 Jun 2025 – Jul 2026
Pinehaven Health Plan 64483 6 89.7% $361.57 Jan 2026 – Jul 2026
Medicare 27447 2 94.4% $345.00 Jul 2025 – Oct 2025
Pinehaven Health Plan 76700 16 89.9% $344.99 Jan 2025 – Jul 2026
Pinehaven Health Plan 99221 26 90.3% $305.93 Feb 2025 – Sep 2026
Pinehaven Health Plan 71250 8 90.2% $303.94 Jan 2025 – Jul 2026
Pinehaven Health Plan 99222 18 89.8% $300.05 Jan 2025 – Jul 2026
Pinehaven Health Plan 77067 18 90.1% $282.28 Jan 2025 – Sep 2026
Pinehaven Health Plan 90834 23 89.8% $266.52 Jan 2025 – Jun 2026
Tricare 19120 2 89.1% $246.29 Sep 2025 – Dec 2025
Pinehaven Health Plan 99202 27 90.0% $223.50 Jan 2025 – Aug 2026
Medicare 29881 2 94.7% $215.00 Aug 2025 – Jul 2026
Medicaid 66984 2 88.3% $192.36 Dec 2025 – Jul 2026
Pinehaven Health Plan 99212 30 90.0% $191.06 Feb 2025 – Sep 2026
Pinehaven Health Plan 99231 21 90.0% $178.94 Jan 2025 – Aug 2026
Pinehaven Health Plan 10060 10 90.4% $151.08 Feb 2025 – Jul 2026
Tricare 49505 1 91.2% $144.01 Dec 2025
Pinehaven Health Plan 84443 31 89.6% $122.04 Jan 2025 – Aug 2026
Pinehaven Health Plan 80061 36 89.9% $119.96 Jan 2025 – Aug 2026
Medicare 66984 2 94.6% $118.00 May 2025 – Nov 2025
Tricare 93306 3 89.0% $116.30 Sep 2025 – Jan 2026
Tricare 66984 1 89.4% $115.51 Feb 2026
Medicaid 62323 3 89.4% $99.99 Jun 2025 – Jun 2026
Medicaid 93306 3 89.4% $99.40 Jun 2025 – Mar 2026
Tricare 99205 5 89.8% $99.39 Jul 2025 – Jul 2026
Medicaid 19120 1 91.4% $95.26 Mar 2026
Pinehaven Health Plan 87070 26 89.8% $93.91 Jan 2025 – Sep 2026
Medicaid 99233 6 90.3% $93.77 Mar 2025 – Aug 2026
Medicaid 99285 4 89.7% $93.38 May 2025 – Jul 2026
Medicare 73721 3 94.2% $91.50 Mar 2025 – Sep 2025
Medicaid 74177 2 88.1% $89.73 Dec 2025
Medicaid 77067 7 89.1% $84.41 Mar 2025 – May 2026
Medicare 49505 1 93.8% $82.50 Apr 2025
Pinehaven Health Plan 99211 30 89.8% $80.55 Jan 2025 – Aug 2026
Medicaid 71250 3 90.6% $80.39 Aug 2025 – Apr 2026
Pinehaven Health Plan 20610 7 89.8% $75.83 Mar 2025 – Nov 2025
Medicaid 99283 8 89.9% $74.44 Feb 2025 – Jan 2026
Medicaid 99204 6 90.8% $72.41 Mar 2025 – Aug 2026
Medicaid 45378 1 88.9% $72.18 May 2026
Medicaid 99223 4 88.9% $69.54 Feb 2025 – Mar 2026
Medicare 19120 1 94.7% $66.00 Jul 2025
Tricare 72148 1 88.1% $65.71 Mar 2025
Medicare 72148 2 93.9% $64.50 Apr 2026 – May 2026
Pinehaven Health Plan 96372 19 89.9% $62.75 Feb 2025 – Sep 2026
Tricare 43239 1 89.5% $61.39 Sep 2026
Medicaid 43239 1 89.5% $59.99 Oct 2025
Pinehaven Health Plan 97110 12 90.0% $58.63 Jan 2025 – Jun 2026
Tricare 73721 1 89.7% $56.39 Oct 2025
Tricare 74177 1 87.8% $54.82 Oct 2025
Tricare 99284 3 90.6% $53.72 May 2025 – Apr 2026
Medicaid 72148 1 90.0% $53.41 Aug 2026
Pinehaven Health Plan 85025 27 90.2% $53.09 Jan 2025 – Jul 2026
Pinehaven Health Plan 93000 17 90.4% $51.75 Mar 2025 – Aug 2026
Tricare 64483 1 89.5% $49.77 Sep 2025
Medicare 76700 5 94.5% $48.75 Jul 2025 – Apr 2026
Pinehaven Health Plan 80053 19 90.0% $47.11 Jan 2025 – Aug 2026
Pinehaven Health Plan 80048 23 89.6% $46.60 Jan 2025 – Jul 2026
Medicaid 99205 3 90.5% $46.51 Jun 2025 – May 2026
Medicare 99285 3 94.4% $44.25 Jun 2025 – May 2026
Medicaid 73721 1 90.7% $41.96 Jan 2026
Medicaid 99213 6 90.4% $41.35 Jul 2025 – Sep 2026
Medicaid 99214 4 89.3% $41.16 Feb 2025 – Mar 2026
Tricare 76700 2 87.8% $39.94 Dec 2025 – Feb 2026
Medicaid 99215 3 90.9% $39.30 Jul 2025 – Jan 2026
Tricare 99223 2 90.4% $38.77 Jul 2025 – Mar 2026
Medicaid 90834 5 90.7% $38.18 Jan 2025 – Apr 2026
Pinehaven Health Plan 83036 15 90.6% $37.58 Jan 2025 – Jun 2026
Medicare 99232 5 94.5% $35.50 Mar 2025 – Sep 2026
Medicare 43239 1 94.6% $34.50 Aug 2026
Medicaid 99232 3 89.7% $34.00 Mar 2025 – Apr 2026
Tricare 99283 3 89.7% $33.07 Oct 2025 – Sep 2026
Tricare 99204 2 89.1% $32.69 Feb 2025 – Aug 2025
Medicare 99205 3 94.2% $31.65 Jan 2025 – Dec 2025
Tricare 99285 1 87.7% $30.03 Jan 2026
Medicare 99203 5 94.6% $27.50 May 2025 – Sep 2026
Pinehaven Health Plan 81001 20 90.0% $26.90 Mar 2025 – Aug 2026
Medicare 64483 1 94.4% $26.00 Nov 2025
Medicaid 99221 3 90.2% $25.74 Jun 2025 – Aug 2026
Medicaid 99222 2 89.4% $24.50 Feb 2025 – Oct 2025
Medicaid 70450 1 88.2% $24.29 Feb 2026
Tricare 99232 2 90.6% $24.21 Sep 2025 – Jul 2026
Tricare 99233 1 87.6% $20.99 Mar 2026
Medicare 93306 1 94.6% $20.75 Oct 2025
Medicaid 84443 7 89.4% $20.07 Jan 2025 – Jul 2026
Tricare 99203 2 89.8% $19.41 Sep 2025 – Jan 2026
Medicare 99215 2 94.5% $18.50 Sep 2025 – Nov 2025
Medicare 71250 1 94.2% $18.25 Nov 2025
Medicaid 97110 5 89.4% $17.92 Jan 2025 – Aug 2026
Medicaid 99212 4 89.9% $17.21 Jul 2025 – Mar 2026
Medicaid 99202 3 89.8% $17.15 Aug 2025 – Aug 2026
Medicaid 99211 9 89.9% $16.77 Jul 2025 – Sep 2026
Medicare 99221 3 94.6% $16.50 Oct 2025 – Sep 2026
Tricare 99213 2 91.2% $15.87 Jul 2025 – Jul 2026
Medicaid 99284 1 90.8% $15.70 Sep 2025
Tricare 99215 1 91.0% $15.64 Oct 2025
Tricare 99212 3 89.9% $15.46 Jan 2025 – Sep 2025
Medicare 77067 2 93.8% $14.50 May 2025 – May 2026
Medicare 70450 1 94.5% $14.25 May 2025
Medicare 99212 5 94.4% $14.25 Feb 2025 – May 2026
Medicaid 76700 1 91.4% $13.52 Apr 2026
Medicare 97110 6 94.3% $13.50 Feb 2025 – Aug 2026
Tricare 99214 1 89.2% $13.26 Sep 2026
Tricare 10060 1 90.7% $13.06 May 2026
Medicaid 20610 2 90.7% $13.04 Aug 2026
Medicaid 10060 1 88.9% $11.88 Feb 2025
Medicare 99283 2 94.5% $11.80 Apr 2025 – Aug 2025
Medicare 99231 3 94.4% $11.70 Oct 2025 – Jan 2026
Medicare 90834 2 94.7% $10.50 Dec 2025 – Jul 2026
Medicare 99233 1 94.3% $10.20 Jul 2026
Tricare 99221 1 90.8% $10.16 May 2025
Medicare 99284 1 93.9% $10.00 Mar 2025
Tricare 99211 4 89.8% $8.99 Aug 2025 – Mar 2026
Tricare 84443 3 90.9% $8.72 Jan 2025 – Jan 2026
Medicaid 80053 5 89.9% $8.69 Jan 2025 – Aug 2026
Tricare 90834 1 90.6% $8.55 Jul 2026
Medicare 99211 7 94.6% $8.40 Feb 2025 – Sep 2026
Tricare 96372 3 90.2% $8.39 Mar 2025 – Jan 2026
Medicare 99204 1 94.6% $8.35 Mar 2025
Medicaid 85025 6 90.0% $8.14 Aug 2025 – Jul 2026
Medicaid 99203 1 90.8% $7.75 Dec 2025
Medicaid 87070 3 90.1% $7.62 Jan 2026 – Aug 2026
Medicare 99202 2 94.5% $7.50 Apr 2025 – Nov 2025
Medicare 99222 1 94.7% $7.50 Oct 2025
Tricare 20610 1 91.3% $7.49 Sep 2025
Medicare 10060 1 94.4% $7.25 Sep 2025
Medicaid 83036 4 89.9% $7.15 Feb 2025 – Aug 2026
Medicaid 96372 3 90.5% $6.74 Mar 2025 – Feb 2026
Tricare 83036 3 89.0% $6.67 Sep 2025 – Jul 2026
Tricare 87070 2 89.5% $6.32 Jul 2025 – Sep 2025
Tricare 99231 1 91.6% $6.25 Mar 2026
Tricare 80061 2 90.1% $5.34 Sep 2025 – Feb 2026
Tricare 85025 3 89.4% $5.12 Feb 2025 – Aug 2026
Medicaid 81001 5 89.8% $4.70 Mar 2025 – Jun 2026
Medicaid 80061 2 89.9% $4.62 Jul 2026
Medicare 99213 1 94.5% $4.60 Mar 2026
Medicare 96372 3 94.4% $4.50 Apr 2025 – Aug 2026
Tricare 80053 2 88.5% $4.38 Feb 2026 – May 2026
Medicare 93000 3 94.5% $4.20 Jan 2025 – Jul 2026
Tricare 97110 1 90.7% $3.89 Jun 2026
Tricare 80048 2 90.0% $3.27 Mar 2026 – Sep 2026
Medicare 87070 2 93.9% $3.20 Apr 2025 – Jan 2026
Tricare 81001 3 90.6% $3.18 Jan 2025 – Aug 2026
Medicare 80061 2 94.7% $3.00 Jul 2025 – Apr 2026
Medicaid 80048 2 90.3% $2.63 May 2026 – Aug 2026
Medicare 81001 4 94.6% $2.40 Feb 2025 – Apr 2026
Medicare 85025 2 94.8% $1.80 May 2026 – Jun 2026
Medicare 84443 1 93.9% $1.75 May 2025
Medicare 83036 1 94.9% $1.20 Apr 2026