UB04 Billing Instructions Guide - Maine

Feb 25, 2021 · List of Figures and Tables. Table 1: MIHMS Provider Types 2. Figure 3 1: FL 1 Billing Provider Name, Address & Telephone 9. Figure 3 2: FL 2 Service Location ID 9. Figure 3 3: FL 3a Patient Control Number 9. Figure 3 4: FL 4 Type of Bill 10. Table 2: Type of Bill by Provider Type 10. Figure 3 5: FL 5 Federal Tax Number 11 ................
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