WebBox 33, Yeah You Know Me! •Box 33 must include the service location name and address, including the ZIP Code+4 as listed on the provider enrollment profile for the billing or group provider. •If the U.S. Postal Service provides an expanded ZIP Code for a geographic area, this expanded ZIP Code must be entered on the claim form. 13 WebNPI number of ordering or referring provider. 2310A or 2420F. NM108. Identifier code qualifier =XX. NM109. Referring NPI ID. 2420E. NM108. Identifier code qualifier =XX. …
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Web2010BB, REF02 (API Number) Box 19 w/G2 qualifier followed by API Number: Box 57 w/G2 qualifier followed by API Number: Billing Provider NPI – required on all claims … WebApr 11, 2024 · CMS-1500 Box # CMS-1500 (02/12) Field Description. ... CMS-1500/field 33; the billing provider shall. enter the '0B' qualifier and the license type, license number, and jurisdiction code ... Billing provider's NPI number is required when. the billing provider is eligible for an NPI. number. 33b. OTHER ID # S. sugar glider backgrounds
How to fill box 33 on CMS 1500 CMS 1500 claim form and UB 04 …
WebEnter the Federal Tax ID Number (employer ID number or SSN) of the Billing Provider identified in Box 33. This is the tax ID number intended to be used for 1099 reporting … Web2010BB, REF02 (API Number) Box 19 w/G2 qualifier followed by API Number: Box 57 w/G2 qualifier followed by API Number: Billing Provider NPI – required on all claims (excluding Atypical Providers) 2010AA, NM109: Box 33a: Box 56: Rendering Provider NPI – required on Professional claims when the Rendering Provider is different from the … WebDec 16, 2024 · By default, the system will use the information under Admin > Member Info to populate Box 33 of your CMS-1500. Group (Yes/No) If the Rendering Provider has been assigned to a Group, that information will … paint the town fred