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61 Cards in this Set
- Front
- Back
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INDEX: supplemental
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63
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INDEX: office visit
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38
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INDEX: routine physical
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38
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INDEX: ob-gyn
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12
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INDEX: deductible
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75
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INDEX: coinsurance
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77
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INDEX: moop
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77-79
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INDEX: lifetime max
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79
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MOOP formula when only the CAT is given
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CAT x Pt's coins = MOOP
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ref? POS plan
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INN NJ
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ref? NJ Direct 10
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no
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ref? NJ Direct 15
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no
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ref? Direct Access
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no
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NJ PV's par status
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PF NASCO active 499
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499, no end date
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INN
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pv's specialty type
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NASCO PV
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pv's office address
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NASCO PV
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pv's CURR FED #
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NASCO PV
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pv's Group Tax ID
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NASCO PV
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BE = ?
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Business entity, group taxid number
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102 - nasco
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single female sub
EM,COV |
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101 - nasco
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single male sub
EM,COV |
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111 - nasco
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husband and wife
EM,COV |
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119 - nasco
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parent and child
EM,COV |
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127 - nasco
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family
EM,COV |
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bill relationship 1
medicare prime? |
no
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bill relationship 2
medicare prime? |
no
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bill relationship 3
medicare prime? |
no
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bill relationship 4
medicare prime? |
yes, 1
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bill relationship 5
medicare prime? |
yes, 2
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MRI benf
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diagnostic
42 |
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CT benf
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diagnostic
42 |
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XRAY
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diagnostic
42 |
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LAB
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diagnostic
42 |
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PET SCAN
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diagnostic
42 |
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CHIRO
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THERAPEUTIC MANIPULATION
42 |
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PT
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THERAPY
42 |
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OT, OCCUPATIONAL THERAPY
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THERAPY
42 |
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SPEECH THERAPY
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THERAPY
42 |
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WIGS
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SUPPLEMENTAL
63 |
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FOOT ORTHOTICS
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SUPPLEMENTAL
63 |
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PROSTHETICS
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SUPPLEMENTAL
63 |
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TIMELY FILING
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GENERAL EXCLUSIONS
96 |
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DIABETIC SUPPLIES
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SUPPLEMENTAL
63 |
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EXTRACTION OF BONY IMPACTED TEETH BY AN ORAL SURGEON
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SURGERY
40 |
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COLONOSCOPY
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SURGERY
40 |
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ENDOSCOPY
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SURGERY
40 |
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MAMMOGRAM
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DIAGNOSTIC
42 |
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VISION CARE
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VISION
61 |
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VISION HARDWARE
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VISION
61 |
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EYE REFRACTIONS
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VISION
61 |
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CHEMOTHERAPY
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THERAPY
42 |
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MANDATED?
|
00
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ASC/ASO = ?
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SELF FUNDED, NOT MANDATED
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SE = ?
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SMALL GROUP, NOT MANDATED
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NASCO SUB NAME SEARCH
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NM(LAST NAME)
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PV NAME SEARCH
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PNLN,PC780
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PT'S AGE
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NN
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XPOL = PIBA, NJ DIRECT = ?
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NAEGS
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N = REGULAR POS, X = ?
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DIRECT ACCESS
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N = REGULAR POS, Y = ?
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NJ DIRECT
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