UB-04 Claim Form | PDF Sponsored Links TheUB-04 claim formmay be used by institutional healthcare providers for submitting insurance claims. Also known as the CMS-1450 form, this is the industry standard for paper billing of all insurance carriers. ...
Blank = Tube -L = Embossed tape on reel 5 = 5 VDC NUN = Minimum footprint 12 = 12 VDC 24 = 24 VDC NEN = Low power consumption (Non-latch), Minimum footprint One world. One KEMET © KEMET Electronics Corporation • P.O. Box 5928 • Greenville, SC 29606 • ...
If the service was not an Emergency leave blank. Not used by Group B providers. FL 22 – Stat Enter the patient status code as it pertains to the status of the patient as of the date of service for Group A providers. Group B providers should enter the status of the patient as it ...
To temporarily turn off the image and darken the screen, press the Blank button on the remote control. Press the Blank button again to return to normal viewing. Setting Up the Projector 23 Positioning the Image If the image is not centered on the screen, use the horizontal and vertical ...
This invention contemplates an improved foldaxble tray blank embodying a single fiatsheet scored longitudinally and transversely to form bottom, side and end panels foldable into overlapping relation on the longitudinal scorings to form ...