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ROW#3

 

FIELD NAME

DEFINITIONS AND EXPLANATIONS

Employee Patient - Provider

Lists the patients and/or providers attached to this claim. Underlined provider names appearing in blue are hyperlinks. Left-click on the name to view provider address and contact information.

Payment

If a payment has been paid towards this claim, the amount paid appears here. If this field is blank, no payment has been made to date.

Check Number

This number identifies the check that is being sent as payment for the amount listed in the Payment column. If no number appears here, no payment has been made to date.

Service Code Description

A short description of the service code(s) used in the Service Code column, above. For more information, contact your Benefit Administrator.

Reason Code Description

A short description of the reason codes used in the Reason Code column.