Your Explanation of Benefits is filled with codes like PR-1, CO-45, OA-23. Translate them into plain English — understand what every code means, why your claim was adjusted, and what to do about it. 100% free, no account needed.
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EOB Codes Translated
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Code Categories (PR, CO, OA, Remarks)
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Try searching "deductible" to see all deductible-related codes, or type "PR-1" for the exact code.
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Found a billing error? Track it with EOBVault.
Once you decode your EOB and spot a discrepancy, EOBVault helps you track every bill, match EOBs to provider bills, monitor your deductible, and log every call with billing departments — all stored privately on your device.
Every Explanation of Benefits (EOB) from your health insurer includes Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs). These codes explain why your claim was paid, reduced, or denied — but they're written in insurance jargon that most people can't understand.
PR Patient Responsibility
These amounts are your responsibility to pay. They represent your deductible, coinsurance, copay, or non-covered services. You owe these amounts to your provider.
CO Contractual Obligation
These are amounts the provider cannot bill you for due to their contract with your insurer. The provider writes these off. You do NOT owe these amounts.
OA Other Adjustment
These adjustments are made for reasons not related to patient or contractual obligation — for example, when another payer (like Medicare or a second insurance plan) paid part of the claim.
N/M Remark Codes
These supplemental codes provide additional context about the claim decision. They often explain what documentation is missing, what steps you need to take, or why a specific denial was issued.
What to Do With Your Decoded EOB
Once you understand what each code means:
PR codes = you owe. Compare the amount to the provider's bill. If they don't match, call the billing office and reference the EOB.
CO codes = you don't owe. If the provider bills you for a CO-adjusted amount, it may be a billing error or potentially illegal balance billing.
OA codes = check who paid. If another payer is involved (Medicare, secondary insurance, workers' comp), make sure coordination of benefits is up to date.
Remark codes = missing information. Most remark codes tell you what documentation, referral, or pre-authorization is needed. Provide it to your provider or insurer to resolve the claim.
Track everything. Use EOBVault to log codes, bills, EOBs, and every call with billing departments. All data stays on your device.
❓ Common questions
What do PR, CO, and OA mean on my EOB?
PR (Patient Responsibility) means the amount is your responsibility — typically your deductible, coinsurance, copay, or non-covered services. CO (Contractual Obligation) means the provider cannot bill you for the amount because of their contract with your insurer — the provider writes it off and you do not owe it. OA (Other Adjustment) means the adjustment was made for another reason, such as another payer (Medicare or a second insurance plan) covering part of the claim.
What does PR-1, PR-2, or PR-3 mean on an EOB?
PR-1 means the amount goes toward your annual deductible, which you have not met yet. PR-2 is coinsurance — your percentage share of the allowed amount after your deductible is met (commonly 20%). PR-3 is a copayment — a fixed fee you pay for that visit or service. All three are amounts you owe.
What does CO-45 mean on my EOB?
CO-45 means the provider's charge exceeds the fee schedule, maximum allowable, or contracted rate with your insurer. You do NOT owe this amount. The difference is written off — in-network providers cannot bill you for it. It is one of the most common EOB adjustment codes.
What are remark codes (N/M) on an EOB?
Remark codes are supplemental codes that add context to a claim decision. They often explain what documentation is missing, what steps you need to take, or why a specific denial was issued. They work alongside the main adjustment code (PR, CO, or OA) on your Explanation of Benefits.
Do I owe the amount shown on my EOB?
Only amounts with PR codes are yours to pay — compare them to the provider's bill and call the billing office if they do not match. CO code amounts are written off by the provider, and OA adjustments typically need no action from you. If a provider bills you for a CO-adjusted amount, reference the EOB when you call.