Claim CLM-2024-8612
Patient
- Name
- Camila Souza
- Date of birth
- 1960-10-09
- Patient id
- H026
Payer
- Name
- Medicare
- Payer id code
- 00882
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Apr 14 (denial date, no service date on file)
- Procedure
- 93015, Cardiac Stress Test
- Diagnosis code
- I25.10
- Billed amount
- $2,400
Denial
- Reason
- Duplicate Claim, code 18
- Date
- Apr 14
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.