CARCContractual Obligation
CARC 94: Processed in excess of charges
The payment calculation came out higher than the amount actually billed, so an adjustment was made.
What this means for your claim
This code appears when the system's calculated payment would exceed the provider's submitted charge. It's typically an administrative reconciliation, not a denial, but it's worth verifying the math.
What to do next
- 1
Compare the billed amount, allowed amount, and payment on your EOB to confirm the totals reconcile.
- 2
If the numbers don't add up, request a detailed claim recalculation from member services.
- 3
Confirm you aren't being asked to pay more than your correct share of the allowed amount.
Have more codes on your EOB?
Upload your full Explanation of Benefits and our analyzer will identify every adjustment code, explain each one in plain English, and flag anything worth disputing.
Analyze My EOB Free →