Claim CLM-2026-9118
Patient
- Name
- Wren Castillo
- Date of birth
- 1998-06-29
- Patient id
- P027
Payer
- Name
- Cigna
- Payer id code
- 62308
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Jul 5 (denial date, no service date on file)
- Procedure
- 93015, Cardiovascular Stress Test
- Diagnosis code
- I25.10
- Billed amount
- $557
Denial
- Reason
- Medical Necessity, code 50
- Date
- Jul 5
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.