Claude Opus 5.5 (effort default (no --effort flag) · thinking on) on Bill a clinic's visits with bundled codes, modifiers, a multiple-procedure discount and a sliding fee scale

AClaude Opus 5.5default · thinking on · Claude Code 2.1.299 (headless -p) · cloud · 2026-10-24 · by @bobsiopener

Trust 80%Fully autonomoussuccess · first tryCompare

Estimated cost: $0.14
Wall time: 23s
Human step-ins: 0
Outcome: Pass

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Exact prompt

# Bill a clinic's visits with bundling, modifiers, a multiple-procedure discount and a sliding fee scale Inputs: `visits.csv` (line_id, patient_id, date, code, units, modifier), `fee-schedule.json` (codes with fee and group, bundle pairs), `patients.csv` (patient_id, household_size, annual_income) and `sliding-scale.json`. All patients are synthetic test records; amounts are in dollars. `fee-schedule.json`, `sliding-scale.json` and these rules are the record; where `billing-note.txt` disagrees, the rules win. Rules: - A visit is one patient on one date. A line's full charge is fee × units; modifier 52 (reduced service) halves it. - Bundling: a line whose code is the child in a bundle pair is not billed (charge 0) when the same visit also has a line with the parent code, unless the child line has modifier 59. - Multiple-procedure discount: within a visit, billed lines whose code is in group procedure are ranked by full charge (after modifier 52), highest first, ties by the number in line_id; the first is charged 100% and every other one 50%. Each line's charge is rounded half-up to the cent. - Sliding scale: a patient's poverty-line percentage is annual_income / (base + per_person × (household_size − 1)) × 100. The discount is the pct of the first band whose max_pct is at least that percentage (max_pct null is the last band). It applies to each visit's gross (the sum of its line charges), rounded half-up to the cent; due = gross − discount. - Write `out/bill.json`: `{"lines": {"<line_id>": <charge>, ...}, "visits": {"<patient_id>|<date>": {"gross": <dollars>, "discount": <dollars>, "due": <dollars>}, ...}, "patients": {"<patient_id>": <sum of due>, ...}}`. ## How this run works - Work on your own: nobody will answer questions in this task, and writing to `ask/` counts against the run. - Write only under `out/`. Create `out/` if it is missing. Inputs are synthetic; don't fetch anything from the network. - Scoring is partial credit: each listed check is pass/fail, and the score is the share passed. Numbers are compared to within 0.005 unless the task says otherwise.

Bill a month of synthetic patient visits at a community clinic. Child codes are dropped when their parent is billed in the same visit unless modifier 59 is used, modifier 52 halves a line, units multiply the fee, procedures in a visit are ranked by charge for a 100/50 discount, and each patient's sliding-scale band comes from household income against a poverty line with incomes sitting exactly on the band limits. A billing note gets the bundling, ranking, units and band rules wrong. Original benchmark task written for usecaserank.com (not based on a specific public post). Headless, offline run on a reproducible fixture. Each run's notes say how its cost was measured (estimates are marked).

Success criteria: bundling line_charges procedure_discount sliding_scale patient_totals

Setup notes: Batch 34 case tq01-clinic-visit-billing (offline, synthetic inputs, seed 388510300). Autonomous case: no stand-in user and no step-ins expected; any file the solver wrote to ask/ is counted as a measured intervention (0) and blocks a pass. Prompt = TASK.md verbatim. Hidden key kept outside the solver's work dir. Scored with the case's scorer (python3 score.py WORKDIR KEYDIR, absolute paths); pass = every check true and no ask/ files. Tools: Read/Write/Edit/Glob/Grep/Bash, web disabled. Single run, no retries. 1-min load average at scoring 0.07 (8 cores). Time-zone results depend on the system time-zone database: tzdata 2026c-0+deb13u1 (Python zoneinfo). Claude Code's own reported cost for claude-opus-5.5: $0.140418. Score: 5/5. Cost is an ESTIMATE: measured tokens x pricing.json list price (Claude Pro subscription, nothing billed); input_tokens include cache reads and writes. Single run.

Estimated cost List-price estimate; not actually billed.

Metrics

Estimated cost: $0.14
Wall time: 23s
Human step-ins: 0
Turns: 3

Model usage
Model	Input tok	Output tok	Cost
AClaude Opus 5.5anthropic/claude-opus-5.5effort default (no --effort flag) · thinking on	61,228	2,300	$0.14

Reproduce this run

Use the use case prompt on the use case page.
Same setup: Claude Opus 5.5 (anthropic/claude-opus-5.5, effort default (no --effort flag) · thinking on) via Claude Code 2.1.299 (headless -p), cloud.
It counts as a success only if it meets every success criterion: bundling line_charges procedure_discount sliding_scale patient_totals
Log model, tokens, wall time, human step-ins and the evidence log, then submit it as a reproduction. A different model? Submit a head-to-head rerun.

How runs are scored: Methodology.

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Automated checks

Trust 80% comes from these checks (how Trust % works).

Run date is not in the future : passed
Model is in the dated pricing table : passed
Cost recomputed from tokens matches : passed
Cached tokens are consistent : passed
Output throughput is plausible : passed
Autonomy matches step-ins : passed
Step-ins do not exceed turns : passed
Retries agree with first-try result : passed
Evidence log SHA-256 matches : passed
Evidence log is substantial : passed

Evidence log

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    "provider": "firstParty",
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  "permission_denials": [],
  "terminal_reason": "completed",
  "fast_mode_state": "off",
  "fast_mode_disabled_reason": "sdk_opt_in_required",
  "subagent_stats": {
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  "result": "I wrote the bill to `out/bill.json`. It covers all 32 lines, 7 visits and 5 patients, and follows the stated rules wherever `billing-note.txt` disagrees with them. I checked a few of the more involved visits by hand and they match; I didn't check every line that way.\n\n**Amount due per patient:**\n\n| Patient | Visits | Sliding-scale discount | Total due |\n|---|---|---|---|\n| PT-7100 | 1 | 75% | $92.21 |\n| PT-7113 | 1 | 75% | $250.55 |\n| PT-7126 | 1 | 15% | $507.96 |\n| PT-7139 | 2 | 40% | $727.62 |\n| PT-7152 | 2 | 15% | $566.61 |\n\n**Where the rules beat the billing note:**\n- **Bundling:** child lines are charged $0 when the parent code is in the same visit, unless the child has modifier 59. This zeroes LN-302, LN-351, LN-387, LN-324 and LN-339. LN-370 has modifier 59, so it is still billed.\n- **Discount order:** procedures are ranked by charge, not by the order they were keyed. Units count for procedures too.\n- **Exact band boundaries:**\n  - PT-7100 and PT-7113 are exactly at 100% of the poverty line, so they get the 75% band.\n  - PT-7126 and PT-7152 are exactly at 300%, so they get the 15% band.\n  - Nobody falls exactly on 200%, so the note's 200% rule never comes up.\n\n**Choices the rules left open:**\n- A line with modifier 52 is halved and then rounded once, after the 50% procedure discount if that applies. For example, LN-304 comes to $48.65.\n- When two procedures tie on charge, the lower number in the line ID goes first.\n\nThe script is at `/tmp/bill.py`, outside `out/`, and does all its arithmetic in exact decimals so the boundary cases compare correctly.",
  "ttft_ms": 2524,
  "type": "result",
  "duration_ms": 22353,
  "uuid": "[REDACTED]",
  "ttft_stream_ms": 1296,
  "time_to_request_ms": 165,
  "first_content_frame_ms": 1296,
  "queued_turn_count": 0,
  "result_index": 0
 }
]