CLM-2025-001847
Lakewood Family Medicine Group · Blue Cross Blue Shield · 837P
⌘K
CLM-2025-001847
PaidLakewood Family Medicine Group · Blue Cross Blue Shield
$842.50
Paid: $638.40
Provider
Dr. Emily Hartman
Patient Ref
PT-44821
Service Date
2025-01-10
Claim Type
837P
Billing Summary
Diagnosis Codes
Z00.00E11.9
Procedure Codes
9921383036
Claim Timeline
Claim created and imported10:01 AM
Received via batch upload
MASE Rules Engine — Scrub initiated10:01 AM
8 rules evaluated
MASE AI Scrub completed10:02 AM
Passed all validation checks
Routed to Claim.MD adapter10:03 AM
claimmd-claims-adapter v2.1
Submitted to payer via Claim.MD10:04 AM
ISA batch 00421 · GS group 004
999 Acknowledgement received10:05 AM
AK2 accepted — Functional Group OK
MASE AI Scrub
Risk Score12 / 100
Scrub ResultPassed
Rules Evaluated8 / 8
AI Modelmase-scrub-v3.1
Claim.MD Transaction Trace
Routing StatusAcknowledged
Ack ResultAccepted
Adapterclaimmd-claims-adapter
ISA Batch00421
Recommended Next Action
No action required. Verify payment posting in ERA module.