UB04 Billing Instructions Guide - Maine

Jun 08, 2020 · fl 8: patient name 11. fl 8a: patient id number 11. fl 8b: patient name 11. fl 9 a — e: patient address 11. fl 10: birthdate 12. fl 11: sex 12. fl 12 – 15: admission 12. fl 12: admission date 13. fl 13: admission hr 13. fl 14: priority of admission or visit 13. fl 15: admission src 13. fl 16: dhr 13. fl 17: stat 14. fl 18 – 28: condition ... ................
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