Physician office revenue for visit code 99214 has a full established rate of $72.00.

Of 10 different payers, there are 9 different contracted rates, as indicated in the template provided below.

For each payer, compute the contractual allowance using the template provided:

GHA 1 Template COLUMN A B C=A-B PAYER FULL RATE CONTRACTED RATE CONTRACTUAL ALLOWANCE FHP $72.00 $37.00 HPHP $72.00 $56.85 MC $72.00 $44.90 UND $72.00 $62.40 CCN $72.00 $70.23 MO $72.00 $61.75 CGN $72.00 $9.00 PRU $72.00 $57.90 PHCS $72.00 $48.00 ANA $72.00 $43.00