ML200 - Intercare Holdings Insurance, Inc.: Grade A

ML200 - Intercare Holdings Insurance, Inc.: Grade A

Claims administrator properly processed reimbursement for ML200. Date of Service: 04/12/2021

MLFS Code(s)

ML200 - Missed Appointment for a Comprehensive or Follow-Up Medical-Legal Evaluation

MLFS Modifier(s)

95 - Evaluation performed by a panel selected Qualified Medical Evaluator

MLFS Grade

A

Claims Administrator

Intercare Holdings Insurance, Inc.

Bill Review Vendor

2CS

Employer

Sacramento Municipal Utility District (SMUD)


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