More reports out the door. Clients send more work.

The charge exactly as the provider billed it. Date, code, description and units are read off the bill and never edited. If the bill says 99284, the sheet says 99284, whatever anyone thinks of it.

Five figures, each a statement of fact. What the provider charged, what the carrier has already paid, what Medicare allows, what the usual and customary benchmark says, and what the sheet carries forward. They are separate columns because they answer separate questions and they routinely disagree by an order of magnitude. No column subtracts one from another, because the difference is the opinion and the opinion is yours.

The half of the sheet that survives cross examination. Every priced line names the code it had to be crosswalked to, the source it was priced from, and the two documents behind it: the bill page and the chart note.

The date on the bill, not the date the note was written. Lines are grouped by provider, then ordered by date inside the group, so a treatment pattern reads down the page.

The CPT or HCPCS code as billed, with the modifier beside it where one was billed. Held as text on purpose: 01992 has to keep its leading zero, and A0427, J1040 and L0650 are not numbers at all. On a DME line the modifier is not decoration: NU and RR select different columns of the same fee schedule.

The published descriptor for the code, shortened to the width of the column, not the provider's own wording. Two bills for the same service then read the same way, which is what makes a pattern visible across providers.

Units as billed. A count above one changes the benchmark, so it stays on the line where it can be checked instead of being folded into a total.

What the carrier has already paid on this line, read off the explanation of benefits. It is not a benchmark, it is a fact, and it changes the question: the supported figure is what is still owed, not what the service is worth. A carrier that has already adjudicated and paid a line has said something about what it considers reasonable, and that outranks a computed benchmark. Blank means nothing has been paid, which is not the same as a payment of zero. On one line here the carrier has already paid more than the sheet supports, and nothing apologizes for it: the rule produced the number.

What the provider charged. Copied from the bill and never adjusted. This column is the only one on the sheet that is not ours.

What Medicare allows for this line. Which Medicare schedule that is depends on who billed it: a hospital outpatient line is priced from the outpatient schedule, a surgery center line from the ASC schedule, a physician line from the physician fee schedule, a drug from the quarterly average sales price file. Same code, different bill type, different number. The 64483 on this sheet appears twice, at $118.88 as the physician's own work in a facility and $477.94 as the surgery center's facility fee, and neither figure is on the schedule the other came from.

The usual and customary benchmark for the same line, at the percentile the policy or the venue calls for. It is a separate column from Medicare because it answers a separate question, and on this sheet the two disagree by as much as eleven times. Blank where a published fee schedule governs outright and a percentile of charges does not apply.

The code this line has to be mapped to before it can be priced at all, and what it maps to depends on who sent the bill. A hospital outpatient line is not paid on its CPT code, it is paid on the payment group that code falls into, so it carries an APC. A surgery center is paid from a different federal file again, Addendum AA. An anesthesia line has no per-procedure rate at all, so it carries the surgical code it was administered for. And a retired code carries the code that replaced it. Blank where the billed code prices directly.

What the sheet carries forward, after the ladder has been walked and any rule on the line applied. It is not always Medicare and not always UCR: on a hospital line here it is the hospitals' own published prices, on a therapy line it is a state daily cap that beats both, and on an inpatient admission it is one figure for the whole stay. It is capped at the billed amount and it is net of nothing: what has already been paid sits in its own column so the two facts stay separable. The Basis column names which rung it came from, every time.

Why a line does not simply take the benchmark beside it, in as few words as the column holds. Point at one and the reason is written out in full. Blank means there is nothing to explain.

Which rung of the ladder the supported figure came from. The order is fixed and it is the same on every line: the fee schedule that governs this bill type if the code is on it, the usual and customary benchmark if it is not, and never more than what was actually billed. Naming the rung is what makes the number reproducible by somebody else. Every basis used on this sheet is written out in full on the Benchmark sources tab.

The page of the bill the charge was read off. In a live report it opens that page. Here it opens the document index, which is the same mechanic against a sample.

The chart note for that date of service. It answers the second question a defense expert asks, which is not what it cost but whether it happened.

This band is on the sample only. A real breakdown carries the claim number, the date of loss and the date it was prepared in its place. What is invented here is the case: the providers, the patient, the dates of service, the charges and the usual and customary figures. What is not invented is the Medicare column. Every figure in it is the published 2025 rate, taken from the file that prices that kind of bill: Addendum B for the hospital outpatient lines, Addendum AA for the surgery center, the physician fee schedule at New Jersey locality 01, the anesthesia conversion factor for the same locality, the ambulance public use file at the New Jersey urban rate, and the equipment schedule at the New Jersey non-rural column. Those are the numbers you can check, so they are the numbers we did not make up.

The two right-hand columns are the reason this is an exhibit and not a spreadsheet. A number nobody can open is an assertion. A number that opens the page it was read off is evidence.

The system prices each line and cites where the price came from. It does not decide what is reasonable. You read it, adjust it and sign it, and your name is the only one on the report.

No source in the loaded set prices this code in this jurisdiction. So the line is flagged and left blank. It is not estimated, and it is not quietly dropped either. It stays on the page with its billed amount and both of its documents, and what happens to it is your call.

Four units of therapeutic exercise on one day. Medicare allows $128.48 and the usual and customary benchmark is $344.72, and neither governs: New Jersey caps physical medicine at $105.00 per patient per day under N.J.A.C. 11:3-29.4(m), across every provider billing that day. So the supported figure is below both published benchmarks, and it is not anyone's opinion. All three figures stay on the row and the note says which rule moved it. The cap does not reach examinations or imaging.

The same epidural injection, on the same day, priced two ways: Medicare allows $118.88 for the physician's work because it was done in a facility, and the usual and customary benchmark for this area is $1,318.72. That is eleven times, and it is not an error in either number. Note which Medicare rate applies: the same code in the doctor's own office allows $269.38, because there the practice expense of the room and the drug sits with him. There is an ambulatory surgery center facility fee on this sheet for the same date, so the facility rate is the right one and the office rate is not. This is the line that decides why both columns are printed instead of one. The Basis says UCR governs here, and that is the judgment being documented.

The 4/2 injection generated three separate bills from three separate parties: the physician's professional fee, this facility fee from the surgery center, and an anesthesia charge. Each is priced from a different Medicare schedule. A review that reads only the physician's bill sees a third of the money.

64483 and 64493 are different procedures and the physician fee schedule pays them differently: $269.38 and $195.65 in an office, $118.88 and $97.46 in a facility. Sent by a surgery center they are not paid on the CPT code at all. They are paid from a third federal file, Addendum AA, where both carry the same payment weight and the identical rate of $477.94. Two codes a physician bill would separate by seventy dollars are the same number here. Nothing on the billed code tells you that, and nothing on the billed code tells you which file governs. The crosswalk column is where both are written down.

A diagnosis related group is assigned from the ICD-10 diagnosis and procedure codes on the inpatient claim, never from a CPT code, so this crosswalk is not what produced the group. It names the operation the stay was for, in the coding system the rest of the sheet is written in, so the group can be read against the operative report. It matters here: 22633 is a single interspace fusion, and single level and multiple level are two different groups paying two different amounts.

This visit carries status indicator J2 in the outpatient file, which makes it a comprehensive payment. When a hospital outpatient claim has nothing ranked above it, the whole encounter pays as one amount and everything else on that claim is packaged into it. The hospital billed $7,790.00 across the three lines of this encounter. Medicare would allow $425.82 for all of it, and that is not a reduction anyone argued for, it is how the payment system is built. The lines below still carry their own charge, their own benchmark and their own documents, because the question a reviewer is answering is not what Medicare would have paid.

The CT is on the same claim as the emergency visit above it, so under Medicare it is packaged into that one comprehensive payment and has no separate rate. It is not unpriceable: it groups to APC 5522, the level 2 imaging group, which pays $106.34 standing alone on a claim of its own. The MRI further down this bill was a separate encounter on a separate date, which is why it does carry its own figure. The Medicare cell says why it is empty rather than leaving a reader to guess, and the market benchmark beside it is unaffected by any of this.

The equipment schedule publishes every fee twice, once for a rural delivery address and once for everywhere else, and the gap is not small. This brace allows $788.33 in non-rural New Jersey and $1,080.91 rural. The four lead stimulator on the line below allows $81.04 non-rural and $303.82 rural, which is nearly four times, for the identical item and the identical code. Nothing on the claim form announces which column applies. The ZIP the item was shipped to decides it, the same way the pickup ZIP decides an ambulance run.

Under the hospital outpatient system a blood draw is not paid on its own. It is packaged into the visit it was drawn during, so there is no separate Medicare rate to print. That is a different answer from a code Medicare has no rate for, and the sheet distinguishes them rather than showing an empty cell for both. The Supported column is not empty on this line, because the market benchmark does price a blood draw even where Medicare does not. The hospital still line-itemed it at $95.00.

J1040 was deleted on 1 April 2024 and folded into J1010, which is billed per milligram rather than per 80 milligram vial. This line carries it on a date of service a year later. There is no schedule that prices a retired code and no benchmark to look it up against, so the line is not priced. It is also not quietly corrected: re-coding somebody else's bill is their job, not ours. The crosswalk column names the successor so the provider can rebill it.

Anesthesia is the one service here with no per-procedure fee at all. It is base units for the procedure plus time units read off the anesthesia record, multiplied by a conversion factor that is not the physician one. Five base units for this procedure plus three time units for forty five minutes, at the $21.94 New Jersey factor rather than the $32.35 physician one. Which procedure supplied the base units is in the Crosswalk column.

On a DME line the modifier is not a detail, it is part of the price. This walker carries three separate published fees for one code: $55.53 bought new with NU, $41.65 bought used with UE, and $5.55 for a month rented with RR. They are three columns of the same file and they are an order of magnitude apart. A review that drops modifiers prices a month of rental as a purchase and lets a nine dollar item through at fifty five.

Five totals, and no two of them cover the same set of lines: almost everything was billed, only some of it has been paid, not every line has a Medicare rate, fewer still have a usual and customary benchmark, and two lines are not priced at all. The count under each figure says how many lines went into it. That matters because dividing one of these totals by another produces a number that means nothing. There is deliberately no sixth figure subtracting one column from another. The sheet reports and cites. Drawing the conclusion is the part you are qualified to do and the system is not.

Medicare pays an inpatient stay as a single amount for the whole admission, set by the diagnosis related group the stay falls into, so the four charge lines above are listed and deliberately left unpriced. That blankness is the point: the pricing unit is the stay, not the line, and re-pricing $54,296.08 of operating room time, implants, bed days and pharmacy one line at a time would be a day of work that changes nothing. Deleting a supply line does not move the payment unless it moves the group. The group itself is checked against the operative report rather than taken off the bill, and it has to be checked against the version of the grouper in force on the discharge date: the spinal fusion groups were renumbered for discharges from 1 October 2024, so a stay in May 2025 cannot carry the number a stay in 2023 carried. Whether a stay is inpatient at all is read off the claim form's bill type, not off the surgeon's description: a same-day discharge is priced line by line like everything else on this sheet.

Two procedures in one session at the same center. The first is supported in full at $955.88 and the second at $477.94, because a multiple procedure reduction takes every procedure after the first to half of its own schedule amount. Half of its own, not half of the first one: they read the same here only because Addendum AA happens to pay both codes the identical $477.94. Add-on codes are exempt from the reduction by rule, and so is any code the file marks as not subject to it, which is why identifying them separately is worth the minute it takes. This is the most common single annotation in real bill review and it is almost always written as three letters with no explanation, so it is spelled out here. Note also that the carrier had already paid the un-reduced amount on this line, so what it has paid now exceeds what the sheet supports. Nothing on the row apologizes for that. The rule produced the number.

The sheet itself. One row per charge line, grouped by provider, with a subtotal under each group.

Every benchmark basis named on the review tab, written out in full: what the source is, and what year it was published for. Thirteen of them on this sample, because seven bill types do not share one price list.

The index every link on the review tab points at. Each document also runs the trace backwards and lists the charge lines that cite it.

Two outpatient encounters on UB-04s, bill type 131. Medicare prices these from the outpatient schedule, and pays an ED visit as one amount for the encounter, not per line. Charges are grouped by the provider that billed them and tagged with the bill type, because the schedule that prices a line depends on who rendered the service, where, and on what form it arrived.

One admission on a UB-04, bill type 111. Medicare pays an inpatient stay as one amount for the whole admission, so the charges below are itemized and deliberately not priced. Charges are grouped by the provider that billed them and tagged with the bill type, because the schedule that prices a line depends on who rendered the service, where, and on what form it arrived.

Professional services on a CMS-1500. Medicare here is the physician fee schedule, at the locality and at the setting each service was performed in. Charges are grouped by the provider that billed them and tagged with the bill type, because the schedule that prices a line depends on who rendered the service, where, and on what form it arrived.

Facility charges from an ambulatory surgery center. Medicare here is the ASC schedule, which is a third set of rates again, and the drug on the bill is priced off none of them. Charges are grouped by the provider that billed them and tagged with the bill type, because the schedule that prices a line depends on who rendered the service, where, and on what form it arrived.

The third bill for the 4/2 injection. Anesthesia is not priced per procedure at all: it is base units plus time units, at its own conversion factor. Charges are grouped by the provider that billed them and tagged with the bill type, because the schedule that prices a line depends on who rendered the service, where, and on what form it arrived.

Transport on a CMS-1500, priced off the ambulance fee schedule for the year and the urban or rural rate for where the pickup happened. Charges are grouped by the provider that billed them and tagged with the bill type, because the schedule that prices a line depends on who rendered the service, where, and on what form it arrived.

Equipment and supplies, priced off the DMEPOS schedule. On these lines the modifier is part of the price: purchased new, purchased used and a month's rental are three columns of the same file. Charges are grouped by the provider that billed them and tagged with the bill type, because the schedule that prices a line depends on who rendered the service, where, and on what form it arrived.

One line, and no source in the loaded set prices this code in this jurisdiction at all. Charges are grouped by the provider that billed them and tagged with the bill type, because the schedule that prices a line depends on who rendered the service, where, and on what form it arrived.

99284 on this sheet was priced from this source. The standard charge file every US hospital has had to publish since 2021, read for the six hospitals in the same market as the billing provider. The supported figure is the 80th percentile of what those six actually accept for the same code. It is computed from their own published files rather than bought, which is why it moves independently of the usual and customary column beside it and sometimes lands above it.

Opens UB-04 p.2 of the Riverbend Regional Medical Center bill, which is the page the 99284 charge of $3,480.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the ed note, 3/4 for 3/4/2025, the record behind the 99284 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

70450 on this sheet was priced from this source. The standard charge file every US hospital has had to publish since 2021, read for the six hospitals in the same market as the billing provider. The supported figure is the 80th percentile of what those six actually accept for the same code. It is computed from their own published files rather than bought, which is why it moves independently of the usual and customary column beside it and sometimes lands above it.

Opens UB-04 p.2 of the Riverbend Regional Medical Center bill, which is the page the 70450 charge of $4,215.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the ct report, 3/4 for 3/4/2025, the record behind the 70450 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

36415 on this sheet was priced from this source. The standard charge file every US hospital has had to publish since 2021, read for the six hospitals in the same market as the billing provider. The supported figure is the 80th percentile of what those six actually accept for the same code. It is computed from their own published files rather than bought, which is why it moves independently of the usual and customary column beside it and sometimes lands above it.

Opens UB-04 p.3 of the Riverbend Regional Medical Center bill, which is the page the 36415 charge of $95.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the lab panel, 3/4 for 3/4/2025, the record behind the 36415 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

72148 on this sheet was priced from this source. The standard charge file every US hospital has had to publish since 2021, read for the six hospitals in the same market as the billing provider. The supported figure is the 80th percentile of what those six actually accept for the same code. It is computed from their own published files rather than bought, which is why it moves independently of the usual and customary column beside it and sometimes lands above it.

Opens UB-04 p.5 of the Riverbend Regional Medical Center bill, which is the page the 72148 charge of $6,890.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the mri report, 3/18 for 3/18/2025, the record behind the 72148 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

0360 on this sheet was priced from this source. The charge is real and it is itemized on the claim, but it is not separately payable: the admission is paid as one amount and this line is inside it. Listing it unpriced is how an inpatient bill is meant to read.

Opens UB-04 p.4 of the Meadowbrook Medical Center bill, which is the page the 0360 charge of $24,900.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the op report, 5/28 for 5/28/2025, the record behind the 0360 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

0278 on this sheet was priced from this source. The charge is real and it is itemized on the claim, but it is not separately payable: the admission is paid as one amount and this line is inside it. Listing it unpriced is how an inpatient bill is meant to read.

Opens UB-04 p.4 of the Meadowbrook Medical Center bill, which is the page the 0278 charge of $17,180.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the op report, 5/28 for 5/28/2025, the record behind the 0278 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

0120 on this sheet was priced from this source. The charge is real and it is itemized on the claim, but it is not separately payable: the admission is paid as one amount and this line is inside it. Listing it unpriced is how an inpatient bill is meant to read.

Opens UB-04 p.5 of the Meadowbrook Medical Center bill, which is the page the 0120 charge of $7,400.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the chart, 5/28 for 5/28/2025, the record behind the 0120 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

0250 on this sheet was priced from this source. The charge is real and it is itemized on the claim, but it is not separately payable: the admission is paid as one amount and this line is inside it. Listing it unpriced is how an inpatient bill is meant to read.

Opens UB-04 p.5 of the Meadowbrook Medical Center bill, which is the page the 0250 charge of $4,816.08 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the chart, 5/28 for 5/28/2025, the record behind the 0250 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

DRG 451 on this sheet was priced from this source. The federal inpatient prospective payment amount for the diagnosis related group the admission falls into, which covers the entire stay rather than any line in it. Unlike every other figure on this sheet the dollar is not one a national file publishes: it is built from the group's relative weight and that hospital's own wage index, teaching and disproportionate share factors, so it is read off the remittance or computed from the hospital's own numbers. The group is verified against the operative report rather than accepted off the claim form.

Opens UB-04 p.4 of the Meadowbrook Medical Center bill, which is the page the DRG 451 line was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the op report, 5/28 for 5/28/2025, the record behind the DRG 451 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

99204 on this sheet was priced from this source. The physician fee schedule at the published federal rate for New Jersey locality 01, read at the facility or the non-facility rate according to the place of service on the claim. The difference is the practice expense of running the room, which sits with whoever owns it.

Opens CMS-1500 p.1 of the Coastal Orthopaedic Associates PA bill, which is the page the 99204 charge of $640.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the office note, 3/19 for 3/19/2025, the record behind the 99204 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

64483 on this sheet was priced from this source. The usual and customary benchmark that governs this case, at the percentile the policy or the venue calls for, for the geographic area the service was rendered in.

Opens CMS-1500 p.2 of the Coastal Orthopaedic Associates PA bill, which is the page the 64483 charge of $4,750.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the proc note, 4/2 for 4/2/2025, the record behind the 64483 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

97110 on this sheet was priced from this source. New Jersey caps physical medicine and rehabilitation at $105.00 per patient per day under N.J.A.C. 11:3-29.4(m), across every provider billing that day, and the cap does not apply to examinations or imaging. It is a ceiling on the day, not a rate for a code, which is why unit count cannot lift it.

Opens CMS-1500 p.4 of the Coastal Orthopaedic Associates PA bill, which is the page the 97110 charge of $880.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the pt sheet, 4/16 for 4/16/2025, the record behind the 97110 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

64483 on this sheet was priced from this source. The federal Medicare ambulatory surgery center file, Addendum AA, at the national unadjusted rate CMS publishes there. A live report applies the wage index for the area the center sits in; on a sample with no real center there is nothing to adjust to. It is a separate file from both the physician fee schedule and the hospital outpatient schedule, and it gives a third answer for the same code.

Opens UB-04 p.1 of the Bayshore Surgery Center LLC bill, which is the page the 64483 charge of $3,900.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the proc note, 4/2 for 4/2/2025, the record behind the 64483 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

64493 on this sheet was priced from this source. The ambulatory surgery center file, with a multiple procedure reduction applied because this was the second procedure in the same session. The first procedure is supported in full and every later one at half of its own schedule amount, not at half of the first one's. Add-on codes are exempt by rule, and so is any code the file marks as not subject to the discount.

Opens UB-04 p.2 of the Bayshore Surgery Center LLC bill, which is the page the 64493 charge of $4,100.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the proc note, 4/2 for 4/2/2025, the record behind the 64493 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

J1040 on this sheet was priced from this source. The code on the bill was retired before the date of service, so no schedule prices it and no benchmark can be looked up against it. The line is left unpriced and the successor code is named in the crosswalk. Correcting the code is the provider's to do, not ours.

Opens UB-04 p.1 of the Bayshore Surgery Center LLC bill, which is the page the J1040 charge of $480.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the proc note, 4/2 for 4/2/2025, the record behind the J1040 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

01992 on this sheet was priced from this source. The anesthesia conversion factor CMS publishes for New Jersey locality 01, $21.94 against a national $20.32, applied to base units plus time units read off the anesthesia record. Anesthesia is the one service on this sheet with no per-procedure rate at all.

Opens CMS-1500 p.1 of the Meridian Anesthesia Group LLC bill, which is the page the 01992 charge of $2,850.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the anes record, 4/2 for 4/2/2025, the record behind the 01992 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

A0427 on this sheet was priced from this source. The ambulance fee schedule public use file, at the New Jersey urban rate for the year the transport happened. Mileage is a separate line and is priced per statute mile.

Opens CMS-1500 p.1 of the Statewide Medical Transport Inc bill, which is the page the A0427 charge of $2,940.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the run report, 3/4 for 3/4/2025, the record behind the A0427 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

A0425 on this sheet was priced from this source. The ambulance fee schedule public use file, at the New Jersey urban rate for the year the transport happened. Mileage is a separate line and is priced per statute mile.

Opens CMS-1500 p.1 of the Statewide Medical Transport Inc bill, which is the page the A0425 charge of $672.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the run report, 3/4 for 3/4/2025, the record behind the A0425 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

L0650 on this sheet was priced from this source. The federal durable medical equipment, prosthetics, orthotics and supplies schedule, at the New Jersey non-rural column. Two things select the cell and neither is the code: the modifier picks purchased new, purchased used or a month's rental, and the delivery address picks rural or non-rural. The same file publishes both, and for some items they are three and four times apart.

Opens CMS-1500 p.1 of the Garden State Medical Supply bill, which is the page the L0650 charge of $1,850.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the dme order, 3/6 for 3/6/2025, the record behind the L0650 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

E0730 on this sheet was priced from this source. The federal durable medical equipment, prosthetics, orthotics and supplies schedule, at the New Jersey non-rural column. Two things select the cell and neither is the code: the modifier picks purchased new, purchased used or a month's rental, and the delivery address picks rural or non-rural. The same file publishes both, and for some items they are three and four times apart.

Opens CMS-1500 p.1 of the Garden State Medical Supply bill, which is the page the E0730 charge of $385.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the dme order, 3/6 for 3/6/2025, the record behind the E0730 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

E0143 on this sheet was priced from this source. The federal durable medical equipment, prosthetics, orthotics and supplies schedule, at the New Jersey non-rural column. Two things select the cell and neither is the code: the modifier picks purchased new, purchased used or a month's rental, and the delivery address picks rural or non-rural. The same file publishes both, and for some items they are three and four times apart.

Opens CMS-1500 p.2 of the Garden State Medical Supply bill, which is the page the E0143 charge of $165.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the dme order, 6/2 for 6/2/2025, the record behind the E0143 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.

S9090 on this sheet was priced from this source. No source in the loaded set prices this code in this jurisdiction. The line is flagged and left unpriced. It is never estimated.

Opens CMS-1500 p.1 of the Harbor Point Spine and Rehab bill, which is the page the S9090 charge of $475.00 was read off. In a live report that is the actual scan in your own environment, one click from the number.

Opens the tx log, 4/23 for 4/23/2025, the record behind the S9090 charge. It answers the second question the other side asks, which is not what the service cost but whether it happened.