25-33
Help!
|
|
||||
|---|---|---|---|---|---|
| Block 25 | Federal Tax ID Number
🗑
|
||||
| Block 26 | Patients Account Number
🗑
|
||||
| Block 27 | Accepts Assignments Yes or No
🗑
|
||||
| Block 28 | Total Charge
🗑
|
||||
| Block 29 | Amount Paid
🗑
|
||||
| Block 30 | Blank NUCC
🗑
|
||||
| Block 31 | Signature of Physician or Supplier and Date
🗑
|
||||
| Block 32 | Service Facility Location Information
🗑
|
||||
| Block 32 a | Service Provider NPI Number
🗑
|
||||
| Block 32 b | Blank
🗑
|
||||
| Block 33 | Billing Provider Info & Phone #
🗑
|
||||
| Block 33 a | Billing Providers NPI Number
🗑
|
||||
| Block 33 b | Blank
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
Leiannlg
Popular Medical sets