Claim CLM-2026-9049
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
- Jul 11 (denial date, no service date on file)
- Procedure
- 93306, Echocardiography, Complete
- Diagnosis code
- I50.9
- Billed amount
- $2,771
Denial
- Reason
- Not Covered, code 96
- Date
- Jul 11
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.