All scenarios
0:00
IntroPrior Auth
The MRI nobody authorized
CLM-100517Professional · 837P
Total billed
$1,850.00
- Member ID
- MBR-0510
- Plan
- Commercial HMO (illustrative)
- Eligibility
- Member eligible on the date of service.
Member & Eligibility
- Name
- Glenpark Imaging Center
- NPI
- NPI-•••••4471
- Network
- In-network
- Specialty
- Diagnostic Radiology
Provider
Service Lines
| # | DOS | CPT/HCPCS | Mods | ICD-10 | POS | Units | Charge |
|---|---|---|---|---|---|---|---|
| 1 | May 9, 2025 | 70553 | — | G44.209 | 11 — Office | 1 | $1,850.00 |
Prior Authorization
Required for advanced imaging under this plan. No authorization request found for this member/service.
Attachments & Notes
- •Auth system checked: no PA on file and no auth request was ever submitted for this member or service.
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