Claim CLM-2026-9066
Patient
- Name
- Hannah Kowalczyk
- Date of birth
- 1955-05-10
- Patient id
- P022
Payer
- Name
- Medicare
- Payer id code
- 00882
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Jun 19 (denial date, no service date on file)
- Procedure
- 93000, Electrocardiogram, Complete
- Diagnosis code
- R00.2
- Billed amount
- $2,656
Denial
- Reason
- Timely Filing, code 29
- Date
- Jun 19
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.