Claim CLM-2026-9064
Patient
- Name
- Quentin Moreau
- Date of birth
- 1975-05-24
- Patient id
- P019
Payer
- Name
- Aetna
- Payer id code
- 60054
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Mar 3 (denial date, no service date on file)
- Procedure
- 97140, Manual Therapy, 15 min
- Diagnosis code
- M54.2
- Billed amount
- $1,137
Denial
- Reason
- Bundling/Coding Error, code 97
- Date
- Mar 3
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.