Sample Report

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SAMPLE
MONTHLY REPORT

 

 

 

 

 

 

 

Codes

Guardian: Original

Guardian: New

$ Difference

%increase

# of claims

Increased Reimbursement

D0120

$32.00

$36.00

$4.00

12.50%

63

$252.00

D0140

$49.00

$52.00

$3.00

6.12%

6

$18.00

D0150

$48.00

$51.00

$3.00

6.25%

13

$39.00

D0210

$94.00

$100.00

$6.00

6.38%

5

$30.00

D0220

$18.00

$19.00

$1.00

5.56%

25

$25.00

D0230

$11.00

$12.00

$1.00

9.09%

11

$11.00

D0240

$28.00

$30.00

$2.00

7.14%

2

$4.00

D0272

$30.00

$32.00

$2.00

6.67%

3

$6.00

D0274

$44.00

$47.00

$3.00

6.82%

13

$39.00

D1110

$62.00

$79.00

$17.00

27.42%

53

$901.00

D1120

$46.00

$51.00

$5.00

10.87%

22

$110.00

D1208

$24.00

$26.00

$2.00

8.33%

20

$40.00

D1351

$34.00

$37.00

$3.00

8.82%

6

$18.00

D2330

$89.00

$98.00

$9.00

10.11%

1

$9.00

D2391

$99.00

$109.00

$10.00

10.10%

3

$30.00

D2392

$124.00

$136.00

$12.00

9.68%

1

$12.00

D2740

$738.00

$854.00

$116.00

15.72%

1

$116.00

D2920

$51.00

$54.00

$3.00

5.88%

1

$3.00

D2940

$52.00

$55.00

$3.00

5.77%

1

$3.00

D2954

$162.00

$172.00

$10.00

6.17%

1

$10.00

D5225

$983.00

$1,042.00

$59.00

6.00%

1

$59.00

D6010

$1,224.00

$1,297.00

$73.00

5.96%

1

$73.00

D7953

$250.00

$265.00

$15.00

6.00%

1

$15.00

D9310

$67.00

$71.00

$4.00

5.97%

2

$8.00

Total Reimbursement

$1,831.00

Average % Increase

8.72%

Total # Claims

256