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12 Sdas

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Edward Curlin
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93 views2 pages

12 Sdas

Uploaded by

Edward Curlin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Real-Time Same or Similar by Episode Alert - CGS C

Date and Time Stamp: 10/09/23 1:44 PM Ran by: Mishamgill24@Gmail.Com (Tasaif Business NPI: 7629316497
Solutions)

Beneficiary's Basic Info


First Name Last Name Medicare # / MBI Date of Birth MAC & Juris HCPCS Entered
betty ottaviano 7V30T78RY11 01/06/1938 CGS C L

Summary Report
SNS Found SNS Found Detail Report Found
Potential Issue found Yes

Same or Similar Found


From / To Category HCPCS Modifier Units Supplier Phone Status
Number
03/30/2022 upper limb orthotics L3916 KXRT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Allowed

03/30/2022 back brace L0650 KX 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Allowed

03/30/2022 knee orthoses L1851 KXRT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Allowed

03/30/2022 orthotic additions L2397 KXRT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Allowed

03/30/2022 knee orthoses L1851 KXLT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Allowed

03/30/2022 orthotic additions L2397 KXLT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Allowed

05/15/2023 elbow orthotics L3761 LT 1.00 ADB MEDICAL SU PPLIES, IN C 630-229-6976 Allowed

05/15/2023 ankle/knee/foot brace L1906 RTKX 1.00 ADB MEDICAL SU PPLIES, IN C 630-229-6976 Allowed

05/15/2023 ankle/knee/foot brace L1906 LTKX 1.00 ADB MEDICAL SU PPLIES, IN C 630-229-6976 Allowed

06/19/2023 upper limb orthotics L3916 LTKX 1.00 NATIONAL HEALT H MEDICS C O 281-826-1919 Allowed

07/28/2023 lower limb orthotics L1690 RTKX 1.00 JUSTRIGHT MEDI CAL EQUIPM E 502-690-4344 Allowed

08/08/2023 elbow orthotics L3761 RTKX 1.00 NATIONAL MEDIC AL EQUIPME N 478-744-1488 Allowed
Additional Claim History
From / To Category HCPCS Modifier Units Supplier Phone Status
Number
03/30/2022 upper limb orthotics L3916 KXRT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Denied

03/30/2022 back brace L0650 KX 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Denied

03/30/2022 knee orthoses L1851 KXRT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Denied

03/30/2022 orthotic additions L2397 KXRT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Denied

03/30/2022 knee orthoses L1851 KXLT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Denied

03/30/2022 orthotic additions L2397 KXLT 1.00 WOLFTECH MEDIC AL LLC 754-212-2187 Denied

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