Claim CLM-2024-8642
Patient
- Name
- Valentina Ruiz
- Date of birth
- 1974-09-12
- Patient id
- H022
Payer
- Name
- BCBS
- Payer id code
- 00210
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Mar 30 (denial date, no service date on file)
- Procedure
- 93015, Cardiac Stress Test
- Diagnosis code
- I25.10
- Billed amount
- $3,600
Denial
- Reason
- Bundling/Coding Error, code 97
- Date
- Mar 30
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.