Claim CLM-2026-9155
Patient
- Name
- Marcus Oyelaran
- Date of birth
- 1986-09-01
- Patient id
- P046
Payer
- Name
- UnitedHealthcare
- Payer id code
- 87726
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Aug 23 (denial date, no service date on file)
- Procedure
- 73721, MRI Lower Extremity Joint
- Diagnosis code
- M23.61
- Billed amount
- $4,204
Denial
- Reason
- Medical Necessity, code 50
- Date
- Aug 23
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.