Claim CLM-2026-9147
Patient
- Name
- Tomas Herrera
- Date of birth
- 1968-02-27
- Patient id
- P014
Payer
- Name
- UnitedHealthcare
- Payer id code
- 87726
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Aug 22 (denial date, no service date on file)
- Procedure
- 93306, Echocardiography, Complete
- Diagnosis code
- I50.9
- Billed amount
- $4,292
Denial
- Reason
- Missing Information, code 16
- Date
- Aug 22
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.