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Claim Record
CLM-2026-0847291Claimant
Maria Santos, 58F
Provider
Northeast Oncology Associates
Claim Amount
$47,283
Procedure (J9271)
Pembrolizumab immunotherapy (4 cycles)
Diagnosis (C34.90)
Non-small cell lung cancer (NSCLC), Stage IIIB
Submitted
2026-02-14
Prior Authorization
PA-2025-99281approved
Claims History
12 claims / 24 months — $184,000
In-Network