Claim CLM-2026-9078
Patient
- Name
- Yusuf Demir
- Date of birth
- 1981-02-20
- Patient id
- P004
Payer
- Name
- Cigna
- Payer id code
- 62308
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Aug 8 (denial date, no service date on file)
- Procedure
- 93015, Cardiovascular Stress Test
- Diagnosis code
- I25.10
- Billed amount
- $2,928
Denial
- Reason
- Pre-Auth Missing, code 197
- Date
- Aug 8
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.