Claim CLM-2024-8804
Patient
- Name
- Clara Oduya
- Date of birth
- 1982-06-19
- Patient id
- H004
Payer
- Name
- Cigna
- Payer id code
- 62308
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Apr 10 (denial date, no service date on file)
- Procedure
- 92920, Coronary Angioplasty
- Diagnosis code
- I25.10
- Billed amount
- $15,800
Denial
- Reason
- Duplicate Claim, code 18
- Date
- Apr 10
Appeal
- Status
- draft
- Tracking id
- None yet
- Submitted
- Not submitted yet
Prepared by Heron on Aug 30.