Claim CLM-2026-9166
Patient
- Name
- Oscar Lindqvist
- Date of birth
- 1995-12-13
- Patient id
- P047
Payer
- Name
- Aetna
- Payer id code
- 60054
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- May 1 (denial date, no service date on file)
- Procedure
- 93015, Cardiovascular Stress Test
- Diagnosis code
- I25.10
- Billed amount
- $1,638
Denial
- Reason
- Missing Information, code 16
- Date
- May 1
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.