CMS 1500 Boxes Flashcards
1
Q
21
A
Diagnosis Code
2
Q
22
A
Resubmission Code
3
Q
23
A
Prior Authorization
4
Q
24( J )
A
Rendering Provider NPI
5
Q
24(D)
A
Procedure Code & Modifier
6
Q
25
A
Federal Tax ID
7
Q
31
A
Provider Name & Signature
8
Q
32
A
Service Address
9
Q
33
A
Facility Address
