PRCDR_CD BILLED_AMT ALOWD_AMT Discount

99213 $65.00 $52.00 -20.00%

99213 $65.00 $63.95 -1.62%

99213 $125.00 $118.53 -5.18%

99213 $90.00 $84.79 -5.79%

99213 $69.00 $59.97 -13.09%

99213 $190.00 $165.11 -13.10%

99213 $108.00 $91.80 -15.00%

99213 $70.00 $59.47 -15.04%

99213 $105.00 $84.79 -19.25%

99213 $75.00 $60.31 -19.59%

99213 $65.00 $52.00 -20.00%

99213 $75.00 $60.00 -20.00%

99213 $75.00 $59.47 -20.71%

99213 $118.00 $91.81 -22.19%

99213 $80.00 $61.11 -23.61%

99213 $85.00 $63.95 -24.76%

99213 $85.00 $63.56 -25.22%

99213 $80.00 $59.46 -25.68%

99213 $90.00 $65.40 -27.33%

99213 $90.00 $63.95 -28.94%

99213 $85.00 $59.47 -30.04%

99213 $147.00 $101.47 -30.97%

99213 $92.00 $60.31 -34.45%

99213 $100.00 $65.40 -34.60%

99213 $162.00 $101.47 -37.36%

99213 $95.00 $59.46 -37.41%

99213 $105.00 $65.40 -37.71%

99213 $100.00 $60.31 -39.69%

99213 $100.00 $60.31 -39.69%

99213 $117.00 $69.43 -40.66%

99213 $112.00 $65.40 -41.61%

99213 $102.00 $59.46 -41.71%

99213 $114.00 $66.10 -42.02%

99213 $117.00 $66.10 -43.50%

99213 $137.00 $76.10 -44.45%

99213 $107.88 $59.46 -44.88%

99213 $110.00 $60.49 -45.01%

99213 $149.00 $76.10 -48.93%

99213 $215.00 $108.51 -49.53%

99213 $120.00 $59.47 -50.44%

99213 $125.00 $60.31 -51.75%

99213 $125.00 $59.46 -52.43%

99213 $137.00 $63.95 -53.32%

99213 $132.00 $60.90 -53.86%

99213 $141.00 $59.46 -57.83%

99213 $152.00 $59.47 -60.88%

99213 $186.00 $60.31 -67.58%

The following data was taken from an actual audit of a large carrier’s claims

history one client. Note the different allowed amounts and what the carrier is

“claiming” to be the discount.

Discount reflected shows

30.97% even though allowed

amount is nearly double the

average allowed amount.