PacificCare Health · Internal Claims Reconciliation — Batch 2026-07-B

Field Key (applies to every row in the reconciliation table at the bottom of this document)

A = Member Full Name
B = Member Date of Birth
C = Member ID
D = Subscriber SSN
E = Diagnosis Code (ICD-10)
F = Provider NPI
G = Billed Amount
H = Plan Paid
— unrelated batch-processing notes and audit log omitted from this export —

Reconciliation rows (columns follow the key defined above; no per-cell labels are repeated here to keep the export compact):

ABCDEFGH
Grace Ellen Marchetti03/17/1982PCP-118820734766-36-8182 E11.91447722910$412.00$328.00
Owen Patrick Sullivan09/29/1975PCP-118820891784-97-1773 I101982004471$198.50$158.80
Devon R. Whitaker05/11/1979PCP-118820734052-41-2536 E78.51447722910$276.00$220.80