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Ub 04 Field Explanation

Ub 04 Field Explanation

Below is an exle of the fields relevant to scenario one and two above field by explanation of the cms 1500 form based physical form ub 04 and state farm medical facility part of understanding bill codes for ub 04 claim forms

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Reserved For Future Use 8 11 Patient Information 12 Admission Date 13

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Rev Cd 43 Description 44 Hcpcs Rates 1 132 2 251

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If There Is No Prinl Procedure Enter The Name And National Provider Identifier Of

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