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Patient
ID
Patient
Case
Date of
Service
Provider
Location
CPT
Units
Insurance Class
Claim Delay Reason
9789990 Chris Allan Case329 01/02/2019 HARVEY PROV, PT MONTV - Centex Corporation 97140 1 IN - WellCare Health Plan Misc hold by clinic (01/01/2039)
9789990 James Peterson Case329 02/02/2019 HARVEY PROV, PT MONTV - Centex Corporation 97140 2 IN - WellCare Health Plan No Authorization (01/01/2016)