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Claim details

Dr. Helen Choi

Primary care visit · Jul 22, 2026

In-network

Cost breakdown

Billed amount$200
Allowed amount$140
Copay$35
Applied to deductible$0
Applied to coinsurance$0
Plan paid$105
You owe (per EOB)$35

Claim CLM-260722-001

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Related benefit

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Primary care visit

$35 copay applies · Medical · Visits