Claim CLM-2026-9161

Patient

Name
Desmond Achebe
Date of birth
1960-06-23
Patient id
P005

Payer

Name
Medicare
Payer id code
00882

Provider

Name
Northside Medical
NPI
1982744321

Service

Date of service
Mar 27 (denial date, no service date on file)
Procedure
97530, Therapeutic Activities, 15 min
Diagnosis code
M62.81
Billed amount
$797

Denial

Reason
Bundling/Coding Error, code 97
Date
Mar 27

Appeal

Status
No appeal filed yet

Prepared by Heron on Aug 30.