United States Health Information Knowledgebase

 

All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Type of Bill - Institutional MC036 August 2011 - v3 Colorado
Type of Bill - Institutional MC036 March 2013 - v5 Colorado
Type of Bill - Institutional MC036 March 2014 - v6 Colorado
Data Element: Type of Bill - Institutional MC036 - August 2011 - v3
(Colorado)
Type of Bill - Institutional MC036 - March 2013 - v5
(Colorado)
Type of Bill - Institutional MC036 - March 2014 - v6
(Colorado)
[Shared]Data Element ID MC036 MC036 MC036
[Shared]Definition Required for institutional claims; Not to be used for professional claims Required for institutional claims; Not to be used for professional claims Required for institutional claims; Not to be used for professional claims
[Shared] State / Source Colorado
Colorado
Colorado
[Shared]Data Type char char char
[Shared]Length 3 3 3
[Unshared]Required O (institutional claims only) O (institutional claims only) R (institutional claims only)
[Unshared]Reference 837/2300/CLM/ /05-1 837/2300/CLM/ /05- 1 837/2300/CLM/ /05- 1
Data Element: Type of Bill - Institutional MC036 - August 2011 - v3
(Colorado)
Type of Bill - Institutional MC036 - March 2013 - v5
(Colorado)
Type of Bill - Institutional MC036 - March 2014 - v6
(Colorado)
[Shared]111 Hospital Inpatient (Including Medicare Part A) Admit Through Discharge Hospital Inpatient (Including Medicare Part A) Admit Through Discharge Hospital Inpatient (Including Medicare Part A) Admit Through Discharge
[Shared]112 Hospital Inpatient (Including Medicare Part A) Interim-First Claim Used for the Hospital Inpatient (Including Medicare Part A) Interim-First Claim Used for the Hospital Inpatient (Including Medicare Part A) Interim-First Claim Used for the
[Shared]113 Hospital Inpatient (Including Medicare Part A) Interim-Continuing Claims Hospital Inpatient (Including Medicare Part A) Interim-Continuing Claims Hospital Inpatient (Including Medicare Part A) Interim-Continuing Claims
[Shared]114 Hospital Inpatient (Including Medicare Part A) Interim-Last Claim Hospital Inpatient (Including Medicare Part A) Interim-Last Claim Hospital Inpatient (Including Medicare Part A) Interim-Last Claim
[Shared]115 Hospital Inpatient (Including Medicare Part A) Late Charge Only Hospital Inpatient (Including Medicare Part A) Late Charge Only Hospital Inpatient (Including Medicare Part A) Late Charge Only
[Shared]117 Hospital Inpatient (Including Medicare Part A) Replacement of Prior Claim Hospital Inpatient (Including Medicare Part A) Replacement of Prior Claim Hospital Inpatient (Including Medicare Part A) Replacement of Prior Claim
[Shared]118 Hospital Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Hospital Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Hospital Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim
[Shared]119 Hospital Inpatient (Including Medicare Part A) Final Claim for a Home Hospital Inpatient (Including Medicare Part A) Final Claim for a Home Hospital Inpatient (Including Medicare Part A) Final Claim for a Home
[Shared]121 Hospital Inpatient (Medicare Part B Only) Admit Through Discharge Hospital Inpatient (Medicare Part B Only) Admit Through Discharge Hospital Inpatient (Medicare Part B Only) Admit Through Discharge
[Shared]122 Hospital Inpatient (Medicare Part B Only) Interim-First Claim Used for the Hospital Inpatient (Medicare Part B Only) Interim-First Claim Used for the Hospital Inpatient (Medicare Part B Only) Interim-First Claim Used for the
[Shared]123 Hospital Inpatient (Medicare Part B Only) Interim-Continuing Claims Hospital Inpatient (Medicare Part B Only) Interim-Continuing Claims Hospital Inpatient (Medicare Part B Only) Interim-Continuing Claims
[Shared]124 Hospital Inpatient (Medicare Part B Only) Interim-Last Claim Hospital Inpatient (Medicare Part B Only) Interim-Last Claim Hospital Inpatient (Medicare Part B Only) Interim-Last Claim
[Shared]125 Hospital Inpatient (Medicare Part B Only) Late Charge Only Hospital Inpatient (Medicare Part B Only) Late Charge Only Hospital Inpatient (Medicare Part B Only) Late Charge Only
[Shared]127 Hospital Inpatient (Medicare Part B Only) Replacement of Prior Claim Hospital Inpatient (Medicare Part B Only) Replacement of Prior Claim Hospital Inpatient (Medicare Part B Only) Replacement of Prior Claim
[Shared]128 Hospital Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Hospital Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Hospital Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim
[Shared]129 Hospital Inpatient (Medicare Part B Only) Final Claim for a Home Hospital Inpatient (Medicare Part B Only) Final Claim for a Home Hospital Inpatient (Medicare Part B Only) Final Claim for a Home
[Shared]131 Hospital Outpatient Admit Through Discharge Hospital Outpatient Admit Through Discharge Hospital Outpatient Admit Through Discharge
[Shared]132 Hospital Outpatient Interim-First Claim Used for the Hospital Outpatient Interim-First Claim Used for the Hospital Outpatient Interim-First Claim Used for the
[Shared]133 Hospital Outpatient Interim-Continuing Claims Hospital Outpatient Interim-Continuing Claims Hospital Outpatient Interim-Continuing Claims
[Shared]134 Hospital Outpatient Interim-Last Claim Hospital Outpatient Interim-Last Claim Hospital Outpatient Interim-Last Claim
[Shared]135 Hospital Outpatient Late Charge Only Hospital Outpatient Late Charge Only Hospital Outpatient Late Charge Only
[Shared]137 Hospital Outpatient Replacement of Prior Claim Hospital Outpatient Replacement of Prior Claim Hospital Outpatient Replacement of Prior Claim
[Shared]138 Hospital Outpatient Void/Cancel of a Prior Claim Hospital Outpatient Void/Cancel of a Prior Claim Hospital Outpatient Void/Cancel of a Prior Claim
[Shared]139 Hospital Outpatient Final Claim for a Home Hospital Outpatient Final Claim for a Home Hospital Outpatient Final Claim for a Home
[Shared]141 Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge
[Shared]142 Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the
[Shared]143 Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims
[Shared]144 Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim
[Shared]145 Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only
[Shared]147 Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim
[Shared]148 Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim
[Shared]149 Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home
[Shared]151 Hospital Nursing Facility Level I Admit Through Discharge Hospital Nursing Facility Level I Admit Through Discharge Hospital Nursing Facility Level I Admit Through Discharge
[Shared]152 Hospital Nursing Facility Level I Interim-First Claim Used for the Hospital Nursing Facility Level I Interim-First Claim Used for the Hospital Nursing Facility Level I Interim-First Claim Used for the
[Shared]153 Hospital Nursing Facility Level I Interim-Continuing Claims Hospital Nursing Facility Level I Interim-Continuing Claims Hospital Nursing Facility Level I Interim-Continuing Claims
[Shared]154 Hospital Nursing Facility Level I Interim-Last Claim Hospital Nursing Facility Level I Interim-Last Claim Hospital Nursing Facility Level I Interim-Last Claim
[Shared]155 Hospital Nursing Facility Level I Late Charge Only Hospital Nursing Facility Level I Late Charge Only Hospital Nursing Facility Level I Late Charge Only
[Shared]157 Hospital Nursing Facility Level I Replacement of Prior Claim Hospital Nursing Facility Level I Replacement of Prior Claim Hospital Nursing Facility Level I Replacement of Prior Claim
[Shared]158 Hospital Nursing Facility Level I Void/Cancel of a Prior Claim Hospital Nursing Facility Level I Void/Cancel of a Prior Claim Hospital Nursing Facility Level I Void/Cancel of a Prior Claim
[Shared]159 Hospital Nursing Facility Level I Final Claim for a Home Hospital Nursing Facility Level I Final Claim for a Home Hospital Nursing Facility Level I Final Claim for a Home
[Shared]161 Hospital Nursing Facility Level II Admit Through Discharge Hospital Nursing Facility Level II Admit Through Discharge Hospital Nursing Facility Level II Admit Through Discharge
[Shared]162 Hospital Nursing Facility Level II Interim-First Claim Used for the Hospital Nursing Facility Level II Interim-First Claim Used for the Hospital Nursing Facility Level II Interim-First Claim Used for the
[Shared]163 Hospital Nursing Facility Level II Interim-Continuing Claims Hospital Nursing Facility Level II Interim-Continuing Claims Hospital Nursing Facility Level II Interim-Continuing Claims
[Shared]164 Hospital Nursing Facility Level II Interim-Last Claim Hospital Nursing Facility Level II Interim-Last Claim Hospital Nursing Facility Level II Interim-Last Claim
[Shared]165 Hospital Nursing Facility Level II Late Charge Only Hospital Nursing Facility Level II Late Charge Only Hospital Nursing Facility Level II Late Charge Only
[Shared]167 Hospital Nursing Facility Level II Replacement of Prior Claim Hospital Nursing Facility Level II Replacement of Prior Claim Hospital Nursing Facility Level II Replacement of Prior Claim
[Shared]168 Hospital Nursing Facility Level II Void/Cancel of a Prior Claim Hospital Nursing Facility Level II Void/Cancel of a Prior Claim Hospital Nursing Facility Level II Void/Cancel of a Prior Claim
[Shared]169 Hospital Nursing Facility Level II Final Claim for a Home Hospital Nursing Facility Level II Final Claim for a Home Hospital Nursing Facility Level II Final Claim for a Home
[Shared]171 Hospital Intermediate Care Level III Nursing Facility Admit Through Discharge Hospital Intermediate Care Level III Nursing Facility Admit Through Discharge Hospital Intermediate Care Level III Nursing Facility Admit Through Discharge
[Shared]172 Hospital Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Hospital Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Hospital Intermediate Care Level III Nursing Facility Interim-First Claim Used for the
[Shared]173 Hospital Intermediate Care Level III Nursing Facility Interim-Continuing Claims Hospital Intermediate Care Level III Nursing Facility Interim-Continuing Claims Hospital Intermediate Care Level III Nursing Facility Interim-Continuing Claims
[Shared]174 Hospital Intermediate Care Level III Nursing Facility Interim-Last Claim Hospital Intermediate Care Level III Nursing Facility Interim-Last Claim Hospital Intermediate Care Level III Nursing Facility Interim-Last Claim
[Shared]175 Hospital Intermediate Care Level III Nursing Facility Late Charge Only Hospital Intermediate Care Level III Nursing Facility Late Charge Only Hospital Intermediate Care Level III Nursing Facility Late Charge Only
[Shared]177 Hospital Intermediate Care Level III Nursing Facility Replacement of Prior Claim Hospital Intermediate Care Level III Nursing Facility Replacement of Prior Claim Hospital Intermediate Care Level III Nursing Facility Replacement of Prior Claim
[Shared]178 Hospital Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Hospital Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Hospital Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim
[Shared]179 Hospital Intermediate Care Level III Nursing Facility Final Claim for a Home Hospital Intermediate Care Level III Nursing Facility Final Claim for a Home Hospital Intermediate Care Level III Nursing Facility Final Claim for a Home
[Shared]181 Hospital Swing Beds Admit Through Discharge Hospital Swing Beds Admit Through Discharge Hospital Swing Beds Admit Through Discharge
[Shared]182 Hospital Swing Beds Interim-First Claim Used for the Hospital Swing Beds Interim-First Claim Used for the Hospital Swing Beds Interim-First Claim Used for the
[Shared]183 Hospital Swing Beds Interim-Continuing Claims Hospital Swing Beds Interim-Continuing Claims Hospital Swing Beds Interim-Continuing Claims
[Shared]184 Hospital Swing Beds Interim-Last Claim Hospital Swing Beds Interim-Last Claim Hospital Swing Beds Interim-Last Claim
[Shared]185 Hospital Swing Beds Late Charge Only Hospital Swing Beds Late Charge Only Hospital Swing Beds Late Charge Only
[Shared]187 Hospital Swing Beds Replacement of Prior Claim Hospital Swing Beds Replacement of Prior Claim Hospital Swing Beds Replacement of Prior Claim
[Shared]188 Hospital Swing Beds Void/Cancel of a Prior Claim Hospital Swing Beds Void/Cancel of a Prior Claim Hospital Swing Beds Void/Cancel of a Prior Claim
[Shared]189 Hospital Swing Beds Final Claim for a Home Hospital Swing Beds Final Claim for a Home Hospital Swing Beds Final Claim for a Home
[Shared]211 Skilled Nursing Inpatient (Including Medicare Part A) Admit Through Discharge Skilled Nursing Inpatient (Including Medicare Part A) Admit Through Discharge Skilled Nursing Inpatient (Including Medicare Part A) Admit Through Discharge
[Shared]212 Skilled Nursing Inpatient (Including Medicare Part A) Interim-First Claim Used for the Skilled Nursing Inpatient (Including Medicare Part A) Interim-First Claim Used for the Skilled Nursing Inpatient (Including Medicare Part A) Interim-First Claim Used for the
[Shared]213 Skilled Nursing Inpatient (Including Medicare Part A) Interim-Continuing Claims Skilled Nursing Inpatient (Including Medicare Part A) Interim-Continuing Claims Skilled Nursing Inpatient (Including Medicare Part A) Interim-Continuing Claims
[Shared]214 Skilled Nursing Inpatient (Including Medicare Part A) Interim-Last Claim Skilled Nursing Inpatient (Including Medicare Part A) Interim-Last Claim Skilled Nursing Inpatient (Including Medicare Part A) Interim-Last Claim
[Shared]215 Skilled Nursing Inpatient (Including Medicare Part A) Late Charge Only Skilled Nursing Inpatient (Including Medicare Part A) Late Charge Only Skilled Nursing Inpatient (Including Medicare Part A) Late Charge Only
[Shared]217 Skilled Nursing Inpatient (Including Medicare Part A) Replacement of Prior Claim Skilled Nursing Inpatient (Including Medicare Part A) Replacement of Prior Claim Skilled Nursing Inpatient (Including Medicare Part A) Replacement of Prior Claim
[Shared]218 Skilled Nursing Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Skilled Nursing Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Skilled Nursing Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim
[Shared]219 Skilled Nursing Inpatient (Including Medicare Part A) Final Claim for a Home Skilled Nursing Inpatient (Including Medicare Part A) Final Claim for a Home Skilled Nursing Inpatient (Including Medicare Part A) Final Claim for a Home
[Shared]221 Skilled Nursing Inpatient (Medicare Part B Only) Admit Through Discharge Skilled Nursing Inpatient (Medicare Part B Only) Admit Through Discharge Skilled Nursing Inpatient (Medicare Part B Only) Admit Through Discharge
[Shared]222 Skilled Nursing Inpatient (Medicare Part B Only) Interim-First Claim Used for the Skilled Nursing Inpatient (Medicare Part B Only) Interim-First Claim Used for the Skilled Nursing Inpatient (Medicare Part B Only) Interim-First Claim Used for the
[Shared]223 Skilled Nursing Inpatient (Medicare Part B Only) Interim-Continuing Claims Skilled Nursing Inpatient (Medicare Part B Only) Interim-Continuing Claims Skilled Nursing Inpatient (Medicare Part B Only) Interim-Continuing Claims
[Shared]224 Skilled Nursing Inpatient (Medicare Part B Only) Interim-Last Claim Skilled Nursing Inpatient (Medicare Part B Only) Interim-Last Claim Skilled Nursing Inpatient (Medicare Part B Only) Interim-Last Claim
[Shared]225 Skilled Nursing Inpatient (Medicare Part B Only) Late Charge Only Skilled Nursing Inpatient (Medicare Part B Only) Late Charge Only Skilled Nursing Inpatient (Medicare Part B Only) Late Charge Only
[Shared]227 Skilled Nursing Inpatient (Medicare Part B Only) Replacement of Prior Claim Skilled Nursing Inpatient (Medicare Part B Only) Replacement of Prior Claim Skilled Nursing Inpatient (Medicare Part B Only) Replacement of Prior Claim
[Shared]228 Skilled Nursing Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Skilled Nursing Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Skilled Nursing Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim
[Shared]229 Skilled Nursing Inpatient (Medicare Part B Only) Final Claim for a Home Skilled Nursing Inpatient (Medicare Part B Only) Final Claim for a Home Skilled Nursing Inpatient (Medicare Part B Only) Final Claim for a Home
[Shared]231 Skilled Nursing Outpatient Admit Through Discharge Skilled Nursing Outpatient Admit Through Discharge Skilled Nursing Outpatient Admit Through Discharge
[Shared]232 Skilled Nursing Outpatient Interim-First Claim Used for the Skilled Nursing Outpatient Interim-First Claim Used for the Skilled Nursing Outpatient Interim-First Claim Used for the
[Shared]233 Skilled Nursing Outpatient Interim-Continuing Claims Skilled Nursing Outpatient Interim-Continuing Claims Skilled Nursing Outpatient Interim-Continuing Claims
[Shared]234 Skilled Nursing Outpatient Interim-Last Claim Skilled Nursing Outpatient Interim-Last Claim Skilled Nursing Outpatient Interim-Last Claim
[Shared]235 Skilled Nursing Outpatient Late Charge Only Skilled Nursing Outpatient Late Charge Only Skilled Nursing Outpatient Late Charge Only
[Shared]237 Skilled Nursing Outpatient Replacement of Prior Claim Skilled Nursing Outpatient Replacement of Prior Claim Skilled Nursing Outpatient Replacement of Prior Claim
[Shared]238 Skilled Nursing Outpatient Void/Cancel of a Prior Claim Skilled Nursing Outpatient Void/Cancel of a Prior Claim Skilled Nursing Outpatient Void/Cancel of a Prior Claim
[Shared]239 Skilled Nursing Outpatient Final Claim for a Home Skilled Nursing Outpatient Final Claim for a Home Skilled Nursing Outpatient Final Claim for a Home
[Shared]241 Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge
[Shared]242 Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the
[Shared]243 Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims
[Shared]244 Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim
[Shared]245 Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only
[Shared]247 Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim
[Shared]248 Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim
[Shared]249 Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Skilled Nursing Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home
[Shared]251 Skilled Nursing Nursing Facility Level I Admit Through Discharge Skilled Nursing Nursing Facility Level I Admit Through Discharge Skilled Nursing Nursing Facility Level I Admit Through Discharge
[Shared]252 Skilled Nursing Nursing Facility Level I Interim-First Claim Used for the Skilled Nursing Nursing Facility Level I Interim-First Claim Used for the Skilled Nursing Nursing Facility Level I Interim-First Claim Used for the
[Shared]253 Skilled Nursing Nursing Facility Level I Interim-Continuing Claims Skilled Nursing Nursing Facility Level I Interim-Continuing Claims Skilled Nursing Nursing Facility Level I Interim-Continuing Claims
[Shared]254 Skilled Nursing Nursing Facility Level I Interim-Last Claim Skilled Nursing Nursing Facility Level I Interim-Last Claim Skilled Nursing Nursing Facility Level I Interim-Last Claim
[Shared]255 Skilled Nursing Nursing Facility Level I Late Charge Only Skilled Nursing Nursing Facility Level I Late Charge Only Skilled Nursing Nursing Facility Level I Late Charge Only
[Shared]257 Skilled Nursing Nursing Facility Level I Replacement of Prior Claim Skilled Nursing Nursing Facility Level I Replacement of Prior Claim Skilled Nursing Nursing Facility Level I Replacement of Prior Claim
[Shared]258 Skilled Nursing Nursing Facility Level I Void/Cancel of a Prior Claim Skilled Nursing Nursing Facility Level I Void/Cancel of a Prior Claim Skilled Nursing Nursing Facility Level I Void/Cancel of a Prior Claim
[Shared]259 Skilled Nursing Nursing Facility Level I Final Claim for a Home Skilled Nursing Nursing Facility Level I Final Claim for a Home Skilled Nursing Nursing Facility Level I Final Claim for a Home
[Shared]261 Skilled Nursing Nursing Facility Level II Admit Through Discharge Skilled Nursing Nursing Facility Level II Admit Through Discharge Skilled Nursing Nursing Facility Level II Admit Through Discharge
[Shared]262 Skilled Nursing Nursing Facility Level II Interim-First Claim Used for the Skilled Nursing Nursing Facility Level II Interim-First Claim Used for the Skilled Nursing Nursing Facility Level II Interim-First Claim Used for the
[Shared]263 Skilled Nursing Nursing Facility Level II Interim-Continuing Claims Skilled Nursing Nursing Facility Level II Interim-Continuing Claims Skilled Nursing Nursing Facility Level II Interim-Continuing Claims
[Shared]264 Skilled Nursing Nursing Facility Level II Interim-Last Claim Skilled Nursing Nursing Facility Level II Interim-Last Claim Skilled Nursing Nursing Facility Level II Interim-Last Claim
[Shared]265 Skilled Nursing Nursing Facility Level II Late Charge Only Skilled Nursing Nursing Facility Level II Late Charge Only Skilled Nursing Nursing Facility Level II Late Charge Only
[Shared]267 Skilled Nursing Nursing Facility Level II Replacement of Prior Claim Skilled Nursing Nursing Facility Level II Replacement of Prior Claim Skilled Nursing Nursing Facility Level II Replacement of Prior Claim
[Shared]268 Skilled Nursing Nursing Facility Level II Void/Cancel of a Prior Claim Skilled Nursing Nursing Facility Level II Void/Cancel of a Prior Claim Skilled Nursing Nursing Facility Level II Void/Cancel of a Prior Claim
[Shared]269 Skilled Nursing Nursing Facility Level II Final Claim for a Home Skilled Nursing Nursing Facility Level II Final Claim for a Home Skilled Nursing Nursing Facility Level II Final Claim for a Home
[Shared]271 Skilled Nursing Intermediate Care Level III Nursing Facility Admit Through Discharge Skilled Nursing Intermediate Care Level III Nursing Facility Admit Through Discharge Skilled Nursing Intermediate Care Level III Nursing Facility Admit Through Discharge
[Shared]272 Skilled Nursing Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Skilled Nursing Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Skilled Nursing Intermediate Care Level III Nursing Facility Interim-First Claim Used for the
[Shared]273 Skilled Nursing Intermediate Care Level III Nursing Facility Interim-Continuing Claims Skilled Nursing Intermediate Care Level III Nursing Facility Interim-Continuing Claims Skilled Nursing Intermediate Care Level III Nursing Facility Interim-Continuing Claims
[Shared]274 Skilled Nursing Intermediate Care Level III Nursing Facility Interim-Last Claim Skilled Nursing Intermediate Care Level III Nursing Facility Interim-Last Claim Skilled Nursing Intermediate Care Level III Nursing Facility Interim-Last Claim
[Shared]275 Skilled Nursing Intermediate Care Level III Nursing Facility Late Charge Only Skilled Nursing Intermediate Care Level III Nursing Facility Late Charge Only Skilled Nursing Intermediate Care Level III Nursing Facility Late Charge Only
[Shared]277 Skilled Nursing Intermediate Care Level III Nursing Facility Replacement of Prior Claim Skilled Nursing Intermediate Care Level III Nursing Facility Replacement of Prior Claim Skilled Nursing Intermediate Care Level III Nursing Facility Replacement of Prior Claim
[Shared]278 Skilled Nursing Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Skilled Nursing Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Skilled Nursing Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim
[Shared]279 Skilled Nursing Intermediate Care Level III Nursing Facility Final Claim for a Home Skilled Nursing Intermediate Care Level III Nursing Facility Final Claim for a Home Skilled Nursing Intermediate Care Level III Nursing Facility Final Claim for a Home
[Shared]281 Skilled Nursing Swing Beds Admit Through Discharge Skilled Nursing Swing Beds Admit Through Discharge Skilled Nursing Swing Beds Admit Through Discharge
[Shared]282 Skilled Nursing Swing Beds Interim-First Claim Used for the Skilled Nursing Swing Beds Interim-First Claim Used for the Skilled Nursing Swing Beds Interim-First Claim Used for the
[Shared]283 Skilled Nursing Swing Beds Interim-Continuing Claims Skilled Nursing Swing Beds Interim-Continuing Claims Skilled Nursing Swing Beds Interim-Continuing Claims
[Shared]284 Skilled Nursing Swing Beds Interim-Last Claim Skilled Nursing Swing Beds Interim-Last Claim Skilled Nursing Swing Beds Interim-Last Claim
[Shared]285 Skilled Nursing Swing Beds Late Charge Only Skilled Nursing Swing Beds Late Charge Only Skilled Nursing Swing Beds Late Charge Only
[Shared]287 Skilled Nursing Swing Beds Replacement of Prior Claim Skilled Nursing Swing Beds Replacement of Prior Claim Skilled Nursing Swing Beds Replacement of Prior Claim
[Shared]288 Skilled Nursing Swing Beds Void/Cancel of a Prior Claim Skilled Nursing Swing Beds Void/Cancel of a Prior Claim Skilled Nursing Swing Beds Void/Cancel of a Prior Claim
[Shared]289 Skilled Nursing Swing Beds Final Claim for a Home Skilled Nursing Swing Beds Final Claim for a Home Skilled Nursing Swing Beds Final Claim for a Home
[Shared]311 Home Health Inpatient (Including Medicare Part A) Admit Through Discharge Home Health Inpatient (Including Medicare Part A) Admit Through Discharge Home Health Inpatient (Including Medicare Part A) Admit Through Discharge
[Shared]312 Home Health Inpatient (Including Medicare Part A) Interim-First Claim Used for the Home Health Inpatient (Including Medicare Part A) Interim-First Claim Used for the Home Health Inpatient (Including Medicare Part A) Interim-First Claim Used for the
[Shared]313 Home Health Inpatient (Including Medicare Part A) Interim-Continuing Claims Home Health Inpatient (Including Medicare Part A) Interim-Continuing Claims Home Health Inpatient (Including Medicare Part A) Interim-Continuing Claims
[Shared]314 Home Health Inpatient (Including Medicare Part A) Interim-Last Claim Home Health Inpatient (Including Medicare Part A) Interim-Last Claim Home Health Inpatient (Including Medicare Part A) Interim-Last Claim
[Shared]315 Home Health Inpatient (Including Medicare Part A) Late Charge Only Home Health Inpatient (Including Medicare Part A) Late Charge Only Home Health Inpatient (Including Medicare Part A) Late Charge Only
[Shared]317 Home Health Inpatient (Including Medicare Part A) Replacement of Prior Claim Home Health Inpatient (Including Medicare Part A) Replacement of Prior Claim Home Health Inpatient (Including Medicare Part A) Replacement of Prior Claim
[Shared]318 Home Health Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Home Health Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Home Health Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim
[Shared]319 Home Health Inpatient (Including Medicare Part A) Final Claim for a Home Home Health Inpatient (Including Medicare Part A) Final Claim for a Home Home Health Inpatient (Including Medicare Part A) Final Claim for a Home
[Shared]321 Home Health Inpatient (Medicare Part B Only) Admit Through Discharge Home Health Inpatient (Medicare Part B Only) Admit Through Discharge Home Health Inpatient (Medicare Part B Only) Admit Through Discharge
[Shared]322 Home Health Inpatient (Medicare Part B Only) Interim-First Claim Used for the Home Health Inpatient (Medicare Part B Only) Interim-First Claim Used for the Home Health Inpatient (Medicare Part B Only) Interim-First Claim Used for the
[Shared]323 Home Health Inpatient (Medicare Part B Only) Interim-Continuing Claims Home Health Inpatient (Medicare Part B Only) Interim-Continuing Claims Home Health Inpatient (Medicare Part B Only) Interim-Continuing Claims
[Shared]324 Home Health Inpatient (Medicare Part B Only) Interim-Last Claim Home Health Inpatient (Medicare Part B Only) Interim-Last Claim Home Health Inpatient (Medicare Part B Only) Interim-Last Claim
[Shared]325 Home Health Inpatient (Medicare Part B Only) Late Charge Only Home Health Inpatient (Medicare Part B Only) Late Charge Only Home Health Inpatient (Medicare Part B Only) Late Charge Only
[Shared]327 Home Health Inpatient (Medicare Part B Only) Replacement of Prior Claim Home Health Inpatient (Medicare Part B Only) Replacement of Prior Claim Home Health Inpatient (Medicare Part B Only) Replacement of Prior Claim
[Shared]328 Home Health Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Home Health Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Home Health Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim
[Shared]329 Home Health Inpatient (Medicare Part B Only) Final Claim for a Home Home Health Inpatient (Medicare Part B Only) Final Claim for a Home Home Health Inpatient (Medicare Part B Only) Final Claim for a Home
[Shared]331 Home Health Outpatient Admit Through Discharge Home Health Outpatient Admit Through Discharge Home Health Outpatient Admit Through Discharge
[Shared]332 Home Health Outpatient Interim-First Claim Used for the Home Health Outpatient Interim-First Claim Used for the Home Health Outpatient Interim-First Claim Used for the
[Shared]333 Home Health Outpatient Interim-Continuing Claims Home Health Outpatient Interim-Continuing Claims Home Health Outpatient Interim-Continuing Claims
[Shared]334 Home Health Outpatient Interim-Last Claim Home Health Outpatient Interim-Last Claim Home Health Outpatient Interim-Last Claim
[Shared]335 Home Health Outpatient Late Charge Only Home Health Outpatient Late Charge Only Home Health Outpatient Late Charge Only
[Shared]337 Home Health Outpatient Replacement of Prior Claim Home Health Outpatient Replacement of Prior Claim Home Health Outpatient Replacement of Prior Claim
[Shared]338 Home Health Outpatient Void/Cancel of a Prior Claim Home Health Outpatient Void/Cancel of a Prior Claim Home Health Outpatient Void/Cancel of a Prior Claim
[Shared]339 Home Health Outpatient Final Claim for a Home Home Health Outpatient Final Claim for a Home Home Health Outpatient Final Claim for a Home
[Shared]341 Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge
[Shared]342 Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the
[Shared]343 Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims
[Shared]344 Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim
[Shared]345 Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only
[Shared]347 Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim
[Shared]348 Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim
[Shared]349 Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Home Health Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home
[Shared]351 Home Health Nursing Facility Level I Admit Through Discharge Home Health Nursing Facility Level I Admit Through Discharge Home Health Nursing Facility Level I Admit Through Discharge
[Shared]352 Home Health Nursing Facility Level I Interim-First Claim Used for the Home Health Nursing Facility Level I Interim-First Claim Used for the Home Health Nursing Facility Level I Interim-First Claim Used for the
[Shared]353 Home Health Nursing Facility Level I Interim-Continuing Claims Home Health Nursing Facility Level I Interim-Continuing Claims Home Health Nursing Facility Level I Interim-Continuing Claims
[Shared]354 Home Health Nursing Facility Level I Interim-Last Claim Home Health Nursing Facility Level I Interim-Last Claim Home Health Nursing Facility Level I Interim-Last Claim
[Shared]355 Home Health Nursing Facility Level I Late Charge Only Home Health Nursing Facility Level I Late Charge Only Home Health Nursing Facility Level I Late Charge Only
[Shared]357 Home Health Nursing Facility Level I Replacement of Prior Claim Home Health Nursing Facility Level I Replacement of Prior Claim Home Health Nursing Facility Level I Replacement of Prior Claim
[Shared]358 Home Health Nursing Facility Level I Void/Cancel of a Prior Claim Home Health Nursing Facility Level I Void/Cancel of a Prior Claim Home Health Nursing Facility Level I Void/Cancel of a Prior Claim
[Shared]359 Home Health Nursing Facility Level I Final Claim for a Home Home Health Nursing Facility Level I Final Claim for a Home Home Health Nursing Facility Level I Final Claim for a Home
[Shared]361 Home Health Nursing Facility Level II Admit Through Discharge Home Health Nursing Facility Level II Admit Through Discharge Home Health Nursing Facility Level II Admit Through Discharge
[Shared]362 Home Health Nursing Facility Level II Interim-First Claim Used for the Home Health Nursing Facility Level II Interim-First Claim Used for the Home Health Nursing Facility Level II Interim-First Claim Used for the
[Shared]363 Home Health Nursing Facility Level II Interim-Continuing Claims Home Health Nursing Facility Level II Interim-Continuing Claims Home Health Nursing Facility Level II Interim-Continuing Claims
[Shared]364 Home Health Nursing Facility Level II Interim-Last Claim Home Health Nursing Facility Level II Interim-Last Claim Home Health Nursing Facility Level II Interim-Last Claim
[Shared]365 Home Health Nursing Facility Level II Late Charge Only Home Health Nursing Facility Level II Late Charge Only Home Health Nursing Facility Level II Late Charge Only
[Shared]367 Home Health Nursing Facility Level II Replacement of Prior Claim Home Health Nursing Facility Level II Replacement of Prior Claim Home Health Nursing Facility Level II Replacement of Prior Claim
[Shared]368 Home Health Nursing Facility Level II Void/Cancel of a Prior Claim Home Health Nursing Facility Level II Void/Cancel of a Prior Claim Home Health Nursing Facility Level II Void/Cancel of a Prior Claim
[Shared]369 Home Health Nursing Facility Level II Final Claim for a Home Home Health Nursing Facility Level II Final Claim for a Home Home Health Nursing Facility Level II Final Claim for a Home
[Shared]371 Home Health Intermediate Care Level III Nursing Facility Admit Through Discharge Home Health Intermediate Care Level III Nursing Facility Admit Through Discharge Home Health Intermediate Care Level III Nursing Facility Admit Through Discharge
[Shared]372 Home Health Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Home Health Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Home Health Intermediate Care Level III Nursing Facility Interim-First Claim Used for the
[Shared]373 Home Health Intermediate Care Level III Nursing Facility Interim-Continuing Claims Home Health Intermediate Care Level III Nursing Facility Interim-Continuing Claims Home Health Intermediate Care Level III Nursing Facility Interim-Continuing Claims
[Shared]374 Home Health Intermediate Care Level III Nursing Facility Interim-Last Claim Home Health Intermediate Care Level III Nursing Facility Interim-Last Claim Home Health Intermediate Care Level III Nursing Facility Interim-Last Claim
[Shared]375 Home Health Intermediate Care Level III Nursing Facility Late Charge Only Home Health Intermediate Care Level III Nursing Facility Late Charge Only Home Health Intermediate Care Level III Nursing Facility Late Charge Only
[Shared]377 Home Health Intermediate Care Level III Nursing Facility Replacement of Prior Claim Home Health Intermediate Care Level III Nursing Facility Replacement of Prior Claim Home Health Intermediate Care Level III Nursing Facility Replacement of Prior Claim
[Shared]378 Home Health Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Home Health Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Home Health Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim
[Shared]379 Home Health Intermediate Care Level III Nursing Facility Final Claim for a Home Home Health Intermediate Care Level III Nursing Facility Final Claim for a Home Home Health Intermediate Care Level III Nursing Facility Final Claim for a Home
[Shared]381 Home Health Swing Beds Admit Through Discharge Home Health Swing Beds Admit Through Discharge Home Health Swing Beds Admit Through Discharge
[Shared]382 Home Health Swing Beds Interim-First Claim Used for the Home Health Swing Beds Interim-First Claim Used for the Home Health Swing Beds Interim-First Claim Used for the
[Shared]383 Home Health Swing Beds Interim-Continuing Claims Home Health Swing Beds Interim-Continuing Claims Home Health Swing Beds Interim-Continuing Claims
[Shared]384 Home Health Swing Beds Interim-Last Claim Home Health Swing Beds Interim-Last Claim Home Health Swing Beds Interim-Last Claim
[Shared]385 Home Health Swing Beds Late Charge Only Home Health Swing Beds Late Charge Only Home Health Swing Beds Late Charge Only
[Shared]387 Home Health Swing Beds Replacement of Prior Claim Home Health Swing Beds Replacement of Prior Claim Home Health Swing Beds Replacement of Prior Claim
[Shared]388 Home Health Swing Beds Void/Cancel of a Prior Claim Home Health Swing Beds Void/Cancel of a Prior Claim Home Health Swing Beds Void/Cancel of a Prior Claim
[Shared]389 Home Health Swing Beds Final Claim for a Home Home Health Swing Beds Final Claim for a Home Home Health Swing Beds Final Claim for a Home
[Shared]411 Christian Science Hospital Inpatient (Including Medicare Part A) Admit Through Discharge Christian Science Hospital Inpatient (Including Medicare Part A) Admit Through Discharge Christian Science Hospital Inpatient (Including Medicare Part A) Admit Through Discharge
[Shared]412 Christian Science Hospital Inpatient (Including Medicare Part A) Interim-First Claim Used for the Christian Science Hospital Inpatient (Including Medicare Part A) Interim-First Claim Used for the Christian Science Hospital Inpatient (Including Medicare Part A) Interim-First Claim Used for the
[Shared]413 Christian Science Hospital Inpatient (Including Medicare Part A) Interim-Continuing Claims Christian Science Hospital Inpatient (Including Medicare Part A) Interim-Continuing Claims Christian Science Hospital Inpatient (Including Medicare Part A) Interim-Continuing Claims
[Shared]414 Christian Science Hospital Inpatient (Including Medicare Part A) Interim-Last Claim Christian Science Hospital Inpatient (Including Medicare Part A) Interim-Last Claim Christian Science Hospital Inpatient (Including Medicare Part A) Interim-Last Claim
[Shared]415 Christian Science Hospital Inpatient (Including Medicare Part A) Late Charge Only Christian Science Hospital Inpatient (Including Medicare Part A) Late Charge Only Christian Science Hospital Inpatient (Including Medicare Part A) Late Charge Only
[Shared]417 Christian Science Hospital Inpatient (Including Medicare Part A) Replacement of Prior Claim Christian Science Hospital Inpatient (Including Medicare Part A) Replacement of Prior Claim Christian Science Hospital Inpatient (Including Medicare Part A) Replacement of Prior Claim
[Shared]418 Christian Science Hospital Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Christian Science Hospital Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Christian Science Hospital Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim
[Shared]419 Christian Science Hospital Inpatient (Including Medicare Part A) Final Claim for a Home Christian Science Hospital Inpatient (Including Medicare Part A) Final Claim for a Home Christian Science Hospital Inpatient (Including Medicare Part A) Final Claim for a Home
[Shared]421 Christian Science Hospital Inpatient (Medicare Part B Only) Admit Through Discharge Christian Science Hospital Inpatient (Medicare Part B Only) Admit Through Discharge Christian Science Hospital Inpatient (Medicare Part B Only) Admit Through Discharge
[Shared]422 Christian Science Hospital Inpatient (Medicare Part B Only) Interim-First Claim Used for the Christian Science Hospital Inpatient (Medicare Part B Only) Interim-First Claim Used for the Christian Science Hospital Inpatient (Medicare Part B Only) Interim-First Claim Used for the
[Shared]423 Christian Science Hospital Inpatient (Medicare Part B Only) Interim-Continuing Claims Christian Science Hospital Inpatient (Medicare Part B Only) Interim-Continuing Claims Christian Science Hospital Inpatient (Medicare Part B Only) Interim-Continuing Claims
[Shared]424 Christian Science Hospital Inpatient (Medicare Part B Only) Interim-Last Claim Christian Science Hospital Inpatient (Medicare Part B Only) Interim-Last Claim Christian Science Hospital Inpatient (Medicare Part B Only) Interim-Last Claim
[Shared]425 Christian Science Hospital Inpatient (Medicare Part B Only) Late Charge Only Christian Science Hospital Inpatient (Medicare Part B Only) Late Charge Only Christian Science Hospital Inpatient (Medicare Part B Only) Late Charge Only
[Shared]427 Christian Science Hospital Inpatient (Medicare Part B Only) Replacement of Prior Claim Christian Science Hospital Inpatient (Medicare Part B Only) Replacement of Prior Claim Christian Science Hospital Inpatient (Medicare Part B Only) Replacement of Prior Claim
[Shared]428 Christian Science Hospital Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Christian Science Hospital Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Christian Science Hospital Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim
[Shared]429 Christian Science Hospital Inpatient (Medicare Part B Only) Final Claim for a Home Christian Science Hospital Inpatient (Medicare Part B Only) Final Claim for a Home Christian Science Hospital Inpatient (Medicare Part B Only) Final Claim for a Home
[Shared]431 Christian Science Hospital Outpatient Admit Through Discharge Christian Science Hospital Outpatient Admit Through Discharge Christian Science Hospital Outpatient Admit Through Discharge
[Shared]432 Christian Science Hospital Outpatient Interim-First Claim Used for the Christian Science Hospital Outpatient Interim-First Claim Used for the Christian Science Hospital Outpatient Interim-First Claim Used for the
[Shared]433 Christian Science Hospital Outpatient Interim-Continuing Claims Christian Science Hospital Outpatient Interim-Continuing Claims Christian Science Hospital Outpatient Interim-Continuing Claims
[Shared]434 Christian Science Hospital Outpatient Interim-Last Claim Christian Science Hospital Outpatient Interim-Last Claim Christian Science Hospital Outpatient Interim-Last Claim
[Shared]435 Christian Science Hospital Outpatient Late Charge Only Christian Science Hospital Outpatient Late Charge Only Christian Science Hospital Outpatient Late Charge Only
[Shared]437 Christian Science Hospital Outpatient Replacement of Prior Claim Christian Science Hospital Outpatient Replacement of Prior Claim Christian Science Hospital Outpatient Replacement of Prior Claim
[Shared]438 Christian Science Hospital Outpatient Void/Cancel of a Prior Claim Christian Science Hospital Outpatient Void/Cancel of a Prior Claim Christian Science Hospital Outpatient Void/Cancel of a Prior Claim
[Shared]439 Christian Science Hospital Outpatient Final Claim for a Home Christian Science Hospital Outpatient Final Claim for a Home Christian Science Hospital Outpatient Final Claim for a Home
[Shared]441 Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge
[Shared]442 Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the
[Shared]443 Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims
[Shared]444 Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim
[Shared]445 Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only
[Shared]447 Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim
[Shared]448 Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim
[Shared]449 Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Christian Science Hospital Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home
[Shared]451 Christian Science Hospital Nursing Facility Level I Admit Through Discharge Christian Science Hospital Nursing Facility Level I Admit Through Discharge Christian Science Hospital Nursing Facility Level I Admit Through Discharge
[Shared]452 Christian Science Hospital Nursing Facility Level I Interim-First Claim Used for the Christian Science Hospital Nursing Facility Level I Interim-First Claim Used for the Christian Science Hospital Nursing Facility Level I Interim-First Claim Used for the
[Shared]453 Christian Science Hospital Nursing Facility Level I Interim-Continuing Claims Christian Science Hospital Nursing Facility Level I Interim-Continuing Claims Christian Science Hospital Nursing Facility Level I Interim-Continuing Claims
[Shared]454 Christian Science Hospital Nursing Facility Level I Interim-Last Claim Christian Science Hospital Nursing Facility Level I Interim-Last Claim Christian Science Hospital Nursing Facility Level I Interim-Last Claim
[Shared]455 Christian Science Hospital Nursing Facility Level I Late Charge Only Christian Science Hospital Nursing Facility Level I Late Charge Only Christian Science Hospital Nursing Facility Level I Late Charge Only
[Shared]457 Christian Science Hospital Nursing Facility Level I Replacement of Prior Claim Christian Science Hospital Nursing Facility Level I Replacement of Prior Claim Christian Science Hospital Nursing Facility Level I Replacement of Prior Claim
[Shared]458 Christian Science Hospital Nursing Facility Level I Void/Cancel of a Prior Claim Christian Science Hospital Nursing Facility Level I Void/Cancel of a Prior Claim Christian Science Hospital Nursing Facility Level I Void/Cancel of a Prior Claim
[Shared]459 Christian Science Hospital Nursing Facility Level I Final Claim for a Home Christian Science Hospital Nursing Facility Level I Final Claim for a Home Christian Science Hospital Nursing Facility Level I Final Claim for a Home
[Shared]461 Christian Science Hospital Nursing Facility Level II Admit Through Discharge Christian Science Hospital Nursing Facility Level II Admit Through Discharge Christian Science Hospital Nursing Facility Level II Admit Through Discharge
[Shared]462 Christian Science Hospital Nursing Facility Level II Interim-First Claim Used for the Christian Science Hospital Nursing Facility Level II Interim-First Claim Used for the Christian Science Hospital Nursing Facility Level II Interim-First Claim Used for the
[Shared]463 Christian Science Hospital Nursing Facility Level II Interim-Continuing Claims Christian Science Hospital Nursing Facility Level II Interim-Continuing Claims Christian Science Hospital Nursing Facility Level II Interim-Continuing Claims
[Shared]464 Christian Science Hospital Nursing Facility Level II Interim-Last Claim Christian Science Hospital Nursing Facility Level II Interim-Last Claim Christian Science Hospital Nursing Facility Level II Interim-Last Claim
[Shared]465 Christian Science Hospital Nursing Facility Level II Late Charge Only Christian Science Hospital Nursing Facility Level II Late Charge Only Christian Science Hospital Nursing Facility Level II Late Charge Only
[Shared]467 Christian Science Hospital Nursing Facility Level II Replacement of Prior Claim Christian Science Hospital Nursing Facility Level II Replacement of Prior Claim Christian Science Hospital Nursing Facility Level II Replacement of Prior Claim
[Shared]468 Christian Science Hospital Nursing Facility Level II Void/Cancel of a Prior Claim Christian Science Hospital Nursing Facility Level II Void/Cancel of a Prior Claim Christian Science Hospital Nursing Facility Level II Void/Cancel of a Prior Claim
[Shared]469 Christian Science Hospital Nursing Facility Level II Final Claim for a Home Christian Science Hospital Nursing Facility Level II Final Claim for a Home Christian Science Hospital Nursing Facility Level II Final Claim for a Home
[Shared]471 Christian Science Hospital Intermediate Care Level III Nursing Facility Admit Through Discharge Christian Science Hospital Intermediate Care Level III Nursing Facility Admit Through Discharge Christian Science Hospital Intermediate Care Level III Nursing Facility Admit Through Discharge
[Shared]472 Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-First Claim Used for the
[Shared]473 Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-Continuing Claims Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-Continuing Claims Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-Continuing Claims
[Shared]474 Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-Last Claim Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-Last Claim Christian Science Hospital Intermediate Care Level III Nursing Facility Interim-Last Claim
[Shared]475 Christian Science Hospital Intermediate Care Level III Nursing Facility Late Charge Only Christian Science Hospital Intermediate Care Level III Nursing Facility Late Charge Only Christian Science Hospital Intermediate Care Level III Nursing Facility Late Charge Only
[Shared]477 Christian Science Hospital Intermediate Care Level III Nursing Facility Replacement of Prior Claim Christian Science Hospital Intermediate Care Level III Nursing Facility Replacement of Prior Claim Christian Science Hospital Intermediate Care Level III Nursing Facility Replacement of Prior Claim
[Shared]478 Christian Science Hospital Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Christian Science Hospital Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Christian Science Hospital Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim
[Shared]479 Christian Science Hospital Intermediate Care Level III Nursing Facility Final Claim for a Home Christian Science Hospital Intermediate Care Level III Nursing Facility Final Claim for a Home Christian Science Hospital Intermediate Care Level III Nursing Facility Final Claim for a Home
[Shared]481 Christian Science Hospital Swing Beds Admit Through Discharge Christian Science Hospital Swing Beds Admit Through Discharge Christian Science Hospital Swing Beds Admit Through Discharge
[Shared]482 Christian Science Hospital Swing Beds Interim-First Claim Used for the Christian Science Hospital Swing Beds Interim-First Claim Used for the Christian Science Hospital Swing Beds Interim-First Claim Used for the
[Shared]483 Christian Science Hospital Swing Beds Interim-Continuing Claims Christian Science Hospital Swing Beds Interim-Continuing Claims Christian Science Hospital Swing Beds Interim-Continuing Claims
[Shared]484 Christian Science Hospital Swing Beds Interim-Last Claim Christian Science Hospital Swing Beds Interim-Last Claim Christian Science Hospital Swing Beds Interim-Last Claim
[Shared]485 Christian Science Hospital Swing Beds Late Charge Only Christian Science Hospital Swing Beds Late Charge Only Christian Science Hospital Swing Beds Late Charge Only
[Shared]487 Christian Science Hospital Swing Beds Replacement of Prior Claim Christian Science Hospital Swing Beds Replacement of Prior Claim Christian Science Hospital Swing Beds Replacement of Prior Claim
[Shared]488 Christian Science Hospital Swing Beds Void/Cancel of a Prior Claim Christian Science Hospital Swing Beds Void/Cancel of a Prior Claim Christian Science Hospital Swing Beds Void/Cancel of a Prior Claim
[Shared]489 Christian Science Hospital Swing Beds Final Claim for a Home Christian Science Hospital Swing Beds Final Claim for a Home Christian Science Hospital Swing Beds Final Claim for a Home
[Shared]511 Christian Science Extended Care Inpatient (Including Medicare Part A) Admit Through Discharge Christian Science Extended Care Inpatient (Including Medicare Part A) Admit Through Discharge Christian Science Extended Care Inpatient (Including Medicare Part A) Admit Through Discharge
[Shared]512 Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-First Claim Used for the Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-First Claim Used for the Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-First Claim Used for the
[Shared]513 Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-Continuing Claims Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-Continuing Claims Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-Continuing Claims
[Shared]514 Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-Last Claim Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-Last Claim Christian Science Extended Care Inpatient (Including Medicare Part A) Interim-Last Claim
[Shared]515 Christian Science Extended Care Inpatient (Including Medicare Part A) Late Charge Only Christian Science Extended Care Inpatient (Including Medicare Part A) Late Charge Only Christian Science Extended Care Inpatient (Including Medicare Part A) Late Charge Only
[Shared]517 Christian Science Extended Care Inpatient (Including Medicare Part A) Replacement of Prior Claim Christian Science Extended Care Inpatient (Including Medicare Part A) Replacement of Prior Claim Christian Science Extended Care Inpatient (Including Medicare Part A) Replacement of Prior Claim
[Shared]518 Christian Science Extended Care Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Christian Science Extended Care Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Christian Science Extended Care Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim
[Shared]519 Christian Science Extended Care Inpatient (Including Medicare Part A) Final Claim for a Home Christian Science Extended Care Inpatient (Including Medicare Part A) Final Claim for a Home Christian Science Extended Care Inpatient (Including Medicare Part A) Final Claim for a Home
[Shared]521 Christian Science Extended Care Inpatient (Medicare Part B Only) Admit Through Discharge Christian Science Extended Care Inpatient (Medicare Part B Only) Admit Through Discharge Christian Science Extended Care Inpatient (Medicare Part B Only) Admit Through Discharge
[Shared]522 Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-First Claim Used for the Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-First Claim Used for the Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-First Claim Used for the
[Shared]523 Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-Continuing Claims Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-Continuing Claims Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-Continuing Claims
[Shared]524 Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-Last Claim Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-Last Claim Christian Science Extended Care Inpatient (Medicare Part B Only) Interim-Last Claim
[Shared]525 Christian Science Extended Care Inpatient (Medicare Part B Only) Late Charge Only Christian Science Extended Care Inpatient (Medicare Part B Only) Late Charge Only Christian Science Extended Care Inpatient (Medicare Part B Only) Late Charge Only
[Shared]527 Christian Science Extended Care Inpatient (Medicare Part B Only) Replacement of Prior Claim Christian Science Extended Care Inpatient (Medicare Part B Only) Replacement of Prior Claim Christian Science Extended Care Inpatient (Medicare Part B Only) Replacement of Prior Claim
[Shared]528 Christian Science Extended Care Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Christian Science Extended Care Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Christian Science Extended Care Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim
[Shared]529 Christian Science Extended Care Inpatient (Medicare Part B Only) Final Claim for a Home Christian Science Extended Care Inpatient (Medicare Part B Only) Final Claim for a Home Christian Science Extended Care Inpatient (Medicare Part B Only) Final Claim for a Home
[Shared]531 Christian Science Extended Care Outpatient Admit Through Discharge Christian Science Extended Care Outpatient Admit Through Discharge Christian Science Extended Care Outpatient Admit Through Discharge
[Shared]532 Christian Science Extended Care Outpatient Interim-First Claim Used for the Christian Science Extended Care Outpatient Interim-First Claim Used for the Christian Science Extended Care Outpatient Interim-First Claim Used for the
[Shared]533 Christian Science Extended Care Outpatient Interim-Continuing Claims Christian Science Extended Care Outpatient Interim-Continuing Claims Christian Science Extended Care Outpatient Interim-Continuing Claims
[Shared]534 Christian Science Extended Care Outpatient Interim-Last Claim Christian Science Extended Care Outpatient Interim-Last Claim Christian Science Extended Care Outpatient Interim-Last Claim
[Shared]535 Christian Science Extended Care Outpatient Late Charge Only Christian Science Extended Care Outpatient Late Charge Only Christian Science Extended Care Outpatient Late Charge Only
[Shared]537 Christian Science Extended Care Outpatient Replacement of Prior Claim Christian Science Extended Care Outpatient Replacement of Prior Claim Christian Science Extended Care Outpatient Replacement of Prior Claim
[Shared]538 Christian Science Extended Care Outpatient Void/Cancel of a Prior Claim Christian Science Extended Care Outpatient Void/Cancel of a Prior Claim Christian Science Extended Care Outpatient Void/Cancel of a Prior Claim
[Shared]539 Christian Science Extended Care Outpatient Final Claim for a Home Christian Science Extended Care Outpatient Final Claim for a Home Christian Science Extended Care Outpatient Final Claim for a Home
[Shared]541 Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge
[Shared]542 Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the
[Shared]543 Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims
[Shared]544 Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim
[Shared]545 Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only
[Shared]547 Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim
[Shared]548 Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim
[Shared]549 Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Christian Science Extended Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home
[Shared]551 Christian Science Extended Care Nursing Facility Level I Admit Through Discharge Christian Science Extended Care Nursing Facility Level I Admit Through Discharge Christian Science Extended Care Nursing Facility Level I Admit Through Discharge
[Shared]552 Christian Science Extended Care Nursing Facility Level I Interim-First Claim Used for the Christian Science Extended Care Nursing Facility Level I Interim-First Claim Used for the Christian Science Extended Care Nursing Facility Level I Interim-First Claim Used for the
[Shared]553 Christian Science Extended Care Nursing Facility Level I Interim-Continuing Claims Christian Science Extended Care Nursing Facility Level I Interim-Continuing Claims Christian Science Extended Care Nursing Facility Level I Interim-Continuing Claims
[Shared]554 Christian Science Extended Care Nursing Facility Level I Interim-Last Claim Christian Science Extended Care Nursing Facility Level I Interim-Last Claim Christian Science Extended Care Nursing Facility Level I Interim-Last Claim
[Shared]555 Christian Science Extended Care Nursing Facility Level I Late Charge Only Christian Science Extended Care Nursing Facility Level I Late Charge Only Christian Science Extended Care Nursing Facility Level I Late Charge Only
[Shared]557 Christian Science Extended Care Nursing Facility Level I Replacement of Prior Claim Christian Science Extended Care Nursing Facility Level I Replacement of Prior Claim Christian Science Extended Care Nursing Facility Level I Replacement of Prior Claim
[Shared]558 Christian Science Extended Care Nursing Facility Level I Void/Cancel of a Prior Claim Christian Science Extended Care Nursing Facility Level I Void/Cancel of a Prior Claim Christian Science Extended Care Nursing Facility Level I Void/Cancel of a Prior Claim
[Shared]559 Christian Science Extended Care Nursing Facility Level I Final Claim for a Home Christian Science Extended Care Nursing Facility Level I Final Claim for a Home Christian Science Extended Care Nursing Facility Level I Final Claim for a Home
[Shared]561 Christian Science Extended Care Nursing Facility Level II Admit Through Discharge Christian Science Extended Care Nursing Facility Level II Admit Through Discharge Christian Science Extended Care Nursing Facility Level II Admit Through Discharge
[Shared]562 Christian Science Extended Care Nursing Facility Level II Interim-First Claim Used for the Christian Science Extended Care Nursing Facility Level II Interim-First Claim Used for the Christian Science Extended Care Nursing Facility Level II Interim-First Claim Used for the
[Shared]563 Christian Science Extended Care Nursing Facility Level II Interim-Continuing Claims Christian Science Extended Care Nursing Facility Level II Interim-Continuing Claims Christian Science Extended Care Nursing Facility Level II Interim-Continuing Claims
[Shared]564 Christian Science Extended Care Nursing Facility Level II Interim-Last Claim Christian Science Extended Care Nursing Facility Level II Interim-Last Claim Christian Science Extended Care Nursing Facility Level II Interim-Last Claim
[Shared]565 Christian Science Extended Care Nursing Facility Level II Late Charge Only Christian Science Extended Care Nursing Facility Level II Late Charge Only Christian Science Extended Care Nursing Facility Level II Late Charge Only
[Shared]567 Christian Science Extended Care Nursing Facility Level II Replacement of Prior Claim Christian Science Extended Care Nursing Facility Level II Replacement of Prior Claim Christian Science Extended Care Nursing Facility Level II Replacement of Prior Claim
[Shared]568 Christian Science Extended Care Nursing Facility Level II Void/Cancel of a Prior Claim Christian Science Extended Care Nursing Facility Level II Void/Cancel of a Prior Claim Christian Science Extended Care Nursing Facility Level II Void/Cancel of a Prior Claim
[Shared]569 Christian Science Extended Care Nursing Facility Level II Final Claim for a Home Christian Science Extended Care Nursing Facility Level II Final Claim for a Home Christian Science Extended Care Nursing Facility Level II Final Claim for a Home
[Shared]571 Christian Science Extended Care Intermediate Care Level III Nursing Facility Admit Through Discharge Christian Science Extended Care Intermediate Care Level III Nursing Facility Admit Through Discharge Christian Science Extended Care Intermediate Care Level III Nursing Facility Admit Through Discharge
[Shared]572 Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-First Claim Used for the
[Shared]573 Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-Continuing Claims Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-Continuing Claims Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-Continuing Claims
[Shared]574 Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-Last Claim Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-Last Claim Christian Science Extended Care Intermediate Care Level III Nursing Facility Interim-Last Claim
[Shared]575 Christian Science Extended Care Intermediate Care Level III Nursing Facility Late Charge Only Christian Science Extended Care Intermediate Care Level III Nursing Facility Late Charge Only Christian Science Extended Care Intermediate Care Level III Nursing Facility Late Charge Only
[Shared]577 Christian Science Extended Care Intermediate Care Level III Nursing Facility Replacement of Prior Claim Christian Science Extended Care Intermediate Care Level III Nursing Facility Replacement of Prior Claim Christian Science Extended Care Intermediate Care Level III Nursing Facility Replacement of Prior Claim
[Shared]578 Christian Science Extended Care Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Christian Science Extended Care Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Christian Science Extended Care Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim
[Shared]579 Christian Science Extended Care Intermediate Care Level III Nursing Facility Final Claim for a Home Christian Science Extended Care Intermediate Care Level III Nursing Facility Final Claim for a Home Christian Science Extended Care Intermediate Care Level III Nursing Facility Final Claim for a Home
[Shared]581 Christian Science Extended Care Swing Beds Admit Through Discharge Christian Science Extended Care Swing Beds Admit Through Discharge Christian Science Extended Care Swing Beds Admit Through Discharge
[Shared]582 Christian Science Extended Care Swing Beds Interim-First Claim Used for the Christian Science Extended Care Swing Beds Interim-First Claim Used for the Christian Science Extended Care Swing Beds Interim-First Claim Used for the
[Shared]583 Christian Science Extended Care Swing Beds Interim-Continuing Claims Christian Science Extended Care Swing Beds Interim-Continuing Claims Christian Science Extended Care Swing Beds Interim-Continuing Claims
[Shared]584 Christian Science Extended Care Swing Beds Interim-Last Claim Christian Science Extended Care Swing Beds Interim-Last Claim Christian Science Extended Care Swing Beds Interim-Last Claim
[Shared]585 Christian Science Extended Care Swing Beds Late Charge Only Christian Science Extended Care Swing Beds Late Charge Only Christian Science Extended Care Swing Beds Late Charge Only
[Shared]587 Christian Science Extended Care Swing Beds Replacement of Prior Claim Christian Science Extended Care Swing Beds Replacement of Prior Claim Christian Science Extended Care Swing Beds Replacement of Prior Claim
[Shared]588 Christian Science Extended Care Swing Beds Void/Cancel of a Prior Claim Christian Science Extended Care Swing Beds Void/Cancel of a Prior Claim Christian Science Extended Care Swing Beds Void/Cancel of a Prior Claim
[Shared]589 Christian Science Extended Care Swing Beds Final Claim for a Home Christian Science Extended Care Swing Beds Final Claim for a Home Christian Science Extended Care Swing Beds Final Claim for a Home
[Shared]611 Intermediate Care Inpatient (Including Medicare Part A) Admit Through Discharge Intermediate Care Inpatient (Including Medicare Part A) Admit Through Discharge Intermediate Care Inpatient (Including Medicare Part A) Admit Through Discharge
[Shared]612 Intermediate Care Inpatient (Including Medicare Part A) Interim-First Claim Used for the Intermediate Care Inpatient (Including Medicare Part A) Interim-First Claim Used for the Intermediate Care Inpatient (Including Medicare Part A) Interim-First Claim Used for the
[Shared]613 Intermediate Care Inpatient (Including Medicare Part A) Interim-Continuing Claims Intermediate Care Inpatient (Including Medicare Part A) Interim-Continuing Claims Intermediate Care Inpatient (Including Medicare Part A) Interim-Continuing Claims
[Shared]614 Intermediate Care Inpatient (Including Medicare Part A) Interim-Last Claim Intermediate Care Inpatient (Including Medicare Part A) Interim-Last Claim Intermediate Care Inpatient (Including Medicare Part A) Interim-Last Claim
[Shared]615 Intermediate Care Inpatient (Including Medicare Part A) Late Charge Only Intermediate Care Inpatient (Including Medicare Part A) Late Charge Only Intermediate Care Inpatient (Including Medicare Part A) Late Charge Only
[Shared]617 Intermediate Care Inpatient (Including Medicare Part A) Replacement of Prior Claim Intermediate Care Inpatient (Including Medicare Part A) Replacement of Prior Claim Intermediate Care Inpatient (Including Medicare Part A) Replacement of Prior Claim
[Shared]618 Intermediate Care Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Intermediate Care Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim Intermediate Care Inpatient (Including Medicare Part A) Void/Cancel of a Prior Claim
[Shared]619 Intermediate Care Inpatient (Including Medicare Part A) Final Claim for a Home Intermediate Care Inpatient (Including Medicare Part A) Final Claim for a Home Intermediate Care Inpatient (Including Medicare Part A) Final Claim for a Home
[Shared]621 Intermediate Care Inpatient (Medicare Part B Only) Admit Through Discharge Intermediate Care Inpatient (Medicare Part B Only) Admit Through Discharge Intermediate Care Inpatient (Medicare Part B Only) Admit Through Discharge
[Shared]622 Intermediate Care Inpatient (Medicare Part B Only) Interim-First Claim Used for the Intermediate Care Inpatient (Medicare Part B Only) Interim-First Claim Used for the Intermediate Care Inpatient (Medicare Part B Only) Interim-First Claim Used for the
[Shared]623 Intermediate Care Inpatient (Medicare Part B Only) Interim-Continuing Claims Intermediate Care Inpatient (Medicare Part B Only) Interim-Continuing Claims Intermediate Care Inpatient (Medicare Part B Only) Interim-Continuing Claims
[Shared]624 Intermediate Care Inpatient (Medicare Part B Only) Interim-Last Claim Intermediate Care Inpatient (Medicare Part B Only) Interim-Last Claim Intermediate Care Inpatient (Medicare Part B Only) Interim-Last Claim
[Shared]625 Intermediate Care Inpatient (Medicare Part B Only) Late Charge Only Intermediate Care Inpatient (Medicare Part B Only) Late Charge Only Intermediate Care Inpatient (Medicare Part B Only) Late Charge Only
[Shared]627 Intermediate Care Inpatient (Medicare Part B Only) Replacement of Prior Claim Intermediate Care Inpatient (Medicare Part B Only) Replacement of Prior Claim Intermediate Care Inpatient (Medicare Part B Only) Replacement of Prior Claim
[Shared]628 Intermediate Care Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Intermediate Care Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim Intermediate Care Inpatient (Medicare Part B Only) Void/Cancel of a Prior Claim
[Shared]629 Intermediate Care Inpatient (Medicare Part B Only) Final Claim for a Home Intermediate Care Inpatient (Medicare Part B Only) Final Claim for a Home Intermediate Care Inpatient (Medicare Part B Only) Final Claim for a Home
[Shared]631 Intermediate Care Outpatient Admit Through Discharge Intermediate Care Outpatient Admit Through Discharge Intermediate Care Outpatient Admit Through Discharge
[Shared]632 Intermediate Care Outpatient Interim-First Claim Used for the Intermediate Care Outpatient Interim-First Claim Used for the Intermediate Care Outpatient Interim-First Claim Used for the
[Shared]633 Intermediate Care Outpatient Interim-Continuing Claims Intermediate Care Outpatient Interim-Continuing Claims Intermediate Care Outpatient Interim-Continuing Claims
[Shared]634 Intermediate Care Outpatient Interim-Last Claim Intermediate Care Outpatient Interim-Last Claim Intermediate Care Outpatient Interim-Last Claim
[Shared]635 Intermediate Care Outpatient Late Charge Only Intermediate Care Outpatient Late Charge Only Intermediate Care Outpatient Late Charge Only
[Shared]637 Intermediate Care Outpatient Replacement of Prior Claim Intermediate Care Outpatient Replacement of Prior Claim Intermediate Care Outpatient Replacement of Prior Claim
[Shared]638 Intermediate Care Outpatient Void/Cancel of a Prior Claim Intermediate Care Outpatient Void/Cancel of a Prior Claim Intermediate Care Outpatient Void/Cancel of a Prior Claim
[Shared]639 Intermediate Care Outpatient Final Claim for a Home Intermediate Care Outpatient Final Claim for a Home Intermediate Care Outpatient Final Claim for a Home
[Shared]641 Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Admit Through Discharge
[Shared]642 Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-First Claim Used for the
[Shared]643 Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Continuing Claims
[Shared]644 Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Interim-Last Claim
[Shared]645 Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Late Charge Only
[Shared]647 Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Replacement of Prior Claim
[Shared]648 Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Void/Cancel of a Prior Claim
[Shared]649 Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home Intermediate Care Other (for hospital referenced diagnostic services or home health not under a plan of treatment) Final Claim for a Home
[Shared]651 Intermediate Care Nursing Facility Level I Admit Through Discharge Intermediate Care Nursing Facility Level I Admit Through Discharge Intermediate Care Nursing Facility Level I Admit Through Discharge
[Shared]652 Intermediate Care Nursing Facility Level I Interim-First Claim Used for the Intermediate Care Nursing Facility Level I Interim-First Claim Used for the Intermediate Care Nursing Facility Level I Interim-First Claim Used for the
[Shared]653 Intermediate Care Nursing Facility Level I Interim-Continuing Claims Intermediate Care Nursing Facility Level I Interim-Continuing Claims Intermediate Care Nursing Facility Level I Interim-Continuing Claims
[Shared]654 Intermediate Care Nursing Facility Level I Interim-Last Claim Intermediate Care Nursing Facility Level I Interim-Last Claim Intermediate Care Nursing Facility Level I Interim-Last Claim
[Shared]655 Intermediate Care Nursing Facility Level I Late Charge Only Intermediate Care Nursing Facility Level I Late Charge Only Intermediate Care Nursing Facility Level I Late Charge Only
[Shared]657 Intermediate Care Nursing Facility Level I Replacement of Prior Claim Intermediate Care Nursing Facility Level I Replacement of Prior Claim Intermediate Care Nursing Facility Level I Replacement of Prior Claim
[Shared]658 Intermediate Care Nursing Facility Level I Void/Cancel of a Prior Claim Intermediate Care Nursing Facility Level I Void/Cancel of a Prior Claim Intermediate Care Nursing Facility Level I Void/Cancel of a Prior Claim
[Shared]659 Intermediate Care Nursing Facility Level I Final Claim for a Home Intermediate Care Nursing Facility Level I Final Claim for a Home Intermediate Care Nursing Facility Level I Final Claim for a Home
[Shared]661 Intermediate Care Nursing Facility Level II Admit Through Discharge Intermediate Care Nursing Facility Level II Admit Through Discharge Intermediate Care Nursing Facility Level II Admit Through Discharge
[Shared]662 Intermediate Care Nursing Facility Level II Interim-First Claim Used for the Intermediate Care Nursing Facility Level II Interim-First Claim Used for the Intermediate Care Nursing Facility Level II Interim-First Claim Used for the
[Shared]663 Intermediate Care Nursing Facility Level II Interim-Continuing Claims Intermediate Care Nursing Facility Level II Interim-Continuing Claims Intermediate Care Nursing Facility Level II Interim-Continuing Claims
[Shared]664 Intermediate Care Nursing Facility Level II Interim-Last Claim Intermediate Care Nursing Facility Level II Interim-Last Claim Intermediate Care Nursing Facility Level II Interim-Last Claim
[Shared]665 Intermediate Care Nursing Facility Level II Late Charge Only Intermediate Care Nursing Facility Level II Late Charge Only Intermediate Care Nursing Facility Level II Late Charge Only
[Shared]667 Intermediate Care Nursing Facility Level II Replacement of Prior Claim Intermediate Care Nursing Facility Level II Replacement of Prior Claim Intermediate Care Nursing Facility Level II Replacement of Prior Claim
[Shared]668 Intermediate Care Nursing Facility Level II Void/Cancel of a Prior Claim Intermediate Care Nursing Facility Level II Void/Cancel of a Prior Claim Intermediate Care Nursing Facility Level II Void/Cancel of a Prior Claim
[Shared]669 Intermediate Care Nursing Facility Level II Final Claim for a Home Intermediate Care Nursing Facility Level II Final Claim for a Home Intermediate Care Nursing Facility Level II Final Claim for a Home
[Shared]671 Intermediate Care Intermediate Care Level III Nursing Facility Admit Through Discharge Intermediate Care Intermediate Care Level III Nursing Facility Admit Through Discharge Intermediate Care Intermediate Care Level III Nursing Facility Admit Through Discharge
[Shared]672 Intermediate Care Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Intermediate Care Intermediate Care Level III Nursing Facility Interim-First Claim Used for the Intermediate Care Intermediate Care Level III Nursing Facility Interim-First Claim Used for the
[Shared]673 Intermediate Care Intermediate Care Level III Nursing Facility Interim-Continuing Claims Intermediate Care Intermediate Care Level III Nursing Facility Interim-Continuing Claims Intermediate Care Intermediate Care Level III Nursing Facility Interim-Continuing Claims
[Shared]674 Intermediate Care Intermediate Care Level III Nursing Facility Interim-Last Claim Intermediate Care Intermediate Care Level III Nursing Facility Interim-Last Claim Intermediate Care Intermediate Care Level III Nursing Facility Interim-Last Claim
[Shared]675 Intermediate Care Intermediate Care Level III Nursing Facility Late Charge Only Intermediate Care Intermediate Care Level III Nursing Facility Late Charge Only Intermediate Care Intermediate Care Level III Nursing Facility Late Charge Only
[Shared]677 Intermediate Care Intermediate Care Level III Nursing Facility Replacement of Prior Claim Intermediate Care Intermediate Care Level III Nursing Facility Replacement of Prior Claim Intermediate Care Intermediate Care Level III Nursing Facility Replacement of Prior Claim
[Shared]678 Intermediate Care Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Intermediate Care Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim Intermediate Care Intermediate Care Level III Nursing Facility Void/Cancel of a Prior Claim
[Shared]679 Intermediate Care Intermediate Care Level III Nursing Facility Final Claim for a Home Intermediate Care Intermediate Care Level III Nursing Facility Final Claim for a Home Intermediate Care Intermediate Care Level III Nursing Facility Final Claim for a Home
[Shared]681 Intermediate Care Swing Beds Admit Through Discharge Intermediate Care Swing Beds Admit Through Discharge Intermediate Care Swing Beds Admit Through Discharge
[Shared]682 Intermediate Care Swing Beds Interim-First Claim Used for the Intermediate Care Swing Beds Interim-First Claim Used for the Intermediate Care Swing Beds Interim-First Claim Used for the
[Shared]683 Intermediate Care Swing Beds Interim-Continuing Claims Intermediate Care Swing Beds Interim-Continuing Claims Intermediate Care Swing Beds Interim-Continuing Claims
[Shared]684 Intermediate Care Swing Beds Interim-Last Claim Intermediate Care Swing Beds Interim-Last Claim Intermediate Care Swing Beds Interim-Last Claim
[Shared]685 Intermediate Care Swing Beds Late Charge Only Intermediate Care Swing Beds Late Charge Only Intermediate Care Swing Beds Late Charge Only
[Shared]687 Intermediate Care Swing Beds Replacement of Prior Claim Intermediate Care Swing Beds Replacement of Prior Claim Intermediate Care Swing Beds Replacement of Prior Claim
[Shared]688 Intermediate Care Swing Beds Void/Cancel of a Prior Claim Intermediate Care Swing Beds Void/Cancel of a Prior Claim Intermediate Care Swing Beds Void/Cancel of a Prior Claim
[Shared]689 Intermediate Care Swing Beds Final Claim for a Home Intermediate Care Swing Beds Final Claim for a Home Intermediate Care Swing Beds Final Claim for a Home
[Shared]711 Clinic Rural HealthAdmit Through Discharge Clinic Rural HealthAdmit Through Discharge Clinic Rural HealthAdmit Through Discharge
[Shared]712 Clinic Rural HealthInterim-First Claim Used for the Clinic Rural HealthInterim-First Claim Used for the Clinic Rural HealthInterim-First Claim Used for the
[Shared]713 Clinic Rural HealthInterim-Continuing Claims Clinic Rural HealthInterim-Continuing Claims Clinic Rural HealthInterim-Continuing Claims
[Shared]714 Clinic Rural HealthInterim-Last Claim Clinic Rural HealthInterim-Last Claim Clinic Rural HealthInterim-Last Claim
[Shared]715 Clinic Rural HealthLate Charge Only Clinic Rural HealthLate Charge Only Clinic Rural HealthLate Charge Only
[Shared]717 Clinic Rural HealthReplacement of Prior Claim Clinic Rural HealthReplacement of Prior Claim Clinic Rural HealthReplacement of Prior Claim
[Shared]718 Clinic Rural HealthVoid/Cancel of a Prior Claim Clinic Rural HealthVoid/Cancel of a Prior Claim Clinic Rural HealthVoid/Cancel of a Prior Claim
[Shared]719 Clinic Rural HealthFinal Claim for a Home Clinic Rural HealthFinal Claim for a Home Clinic Rural HealthFinal Claim for a Home
[Shared]721 Clinic Hospital Based or Independent Renal Dialysis CenterAdmit Through Discharge Clinic Hospital Based or Independent Renal Dialysis CenterAdmit Through Discharge Clinic Hospital Based or Independent Renal Dialysis CenterAdmit Through Discharge
[Shared]722 Clinic Hospital Based or Independent Renal Dialysis CenterInterim-First Claim Used for the Clinic Hospital Based or Independent Renal Dialysis CenterInterim-First Claim Used for the Clinic Hospital Based or Independent Renal Dialysis CenterInterim-First Claim Used for the
[Shared]723 Clinic Hospital Based or Independent Renal Dialysis CenterInterim-Continuing Claims Clinic Hospital Based or Independent Renal Dialysis CenterInterim-Continuing Claims Clinic Hospital Based or Independent Renal Dialysis CenterInterim-Continuing Claims
[Shared]724 Clinic Hospital Based or Independent Renal Dialysis CenterInterim-Last Claim Clinic Hospital Based or Independent Renal Dialysis CenterInterim-Last Claim Clinic Hospital Based or Independent Renal Dialysis CenterInterim-Last Claim
[Shared]725 Clinic Hospital Based or Independent Renal Dialysis CenterLate Charge Only Clinic Hospital Based or Independent Renal Dialysis CenterLate Charge Only Clinic Hospital Based or Independent Renal Dialysis CenterLate Charge Only
[Shared]727 Clinic Hospital Based or Independent Renal Dialysis CenterReplacement of Prior Claim Clinic Hospital Based or Independent Renal Dialysis CenterReplacement of Prior Claim Clinic Hospital Based or Independent Renal Dialysis CenterReplacement of Prior Claim
[Shared]728 Clinic Hospital Based or Independent Renal Dialysis CenterVoid/Cancel of a Prior Claim Clinic Hospital Based or Independent Renal Dialysis CenterVoid/Cancel of a Prior Claim Clinic Hospital Based or Independent Renal Dialysis CenterVoid/Cancel of a Prior Claim
[Shared]729 Clinic Hospital Based or Independent Renal Dialysis CenterFinal Claim for a Home Clinic Hospital Based or Independent Renal Dialysis CenterFinal Claim for a Home Clinic Hospital Based or Independent Renal Dialysis CenterFinal Claim for a Home
[Shared]731 Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Admit Through Discharge Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Admit Through Discharge Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Admit Through Discharge
[Shared]732 Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-First Claim Used for the Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-First Claim Used for the Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-First Claim Used for the
[Shared]733 Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-Continuing Claims Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-Continuing Claims Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-Continuing Claims
[Shared]734 Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-Last Claim Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-Last Claim Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Interim-Last Claim
[Shared]735 Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Late Charge Only Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Late Charge Only Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Late Charge Only
[Shared]737 Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Replacement of Prior Claim Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Replacement of Prior Claim Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Replacement of Prior Claim
[Shared]738 Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Void/Cancel of a Prior Claim Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Void/Cancel of a Prior Claim Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Void/Cancel of a Prior Claim
[Shared]739 Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Final Claim for a Home Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Final Claim for a Home Clinic Free Standing Outpatient Rehabilitation Facility (ORF)Final Claim for a Home
[Shared]751 Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Admit Through Discharge Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Admit Through Discharge Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Admit Through Discharge
[Shared]752 Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-First Claim Used for the Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-First Claim Used for the Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-First Claim Used for the
[Shared]753 Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-Continuing Claims Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-Continuing Claims Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-Continuing Claims
[Shared]754 Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-Last Claim Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-Last Claim Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Interim-Last Claim
[Shared]755 Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Late Charge Only Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Late Charge Only Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Late Charge Only
[Shared]757 Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Replacement of Prior Claim Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Replacement of Prior Claim Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Replacement of Prior Claim
[Shared]758 Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Void/Cancel of a Prior Claim Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Void/Cancel of a Prior Claim Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Void/Cancel of a Prior Claim
[Shared]759 Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Final Claim for a Home Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Final Claim for a Home Clinic Comprehensive Outpatient Rehabilitation Facilities (CORFs)Final Claim for a Home
[Shared]761 Clinic Community Mental Health CenterAdmit Through Discharge Clinic Community Mental Health CenterAdmit Through Discharge Clinic Community Mental Health CenterAdmit Through Discharge
[Shared]762 Clinic Community Mental Health CenterInterim-First Claim Used for the Clinic Community Mental Health CenterInterim-First Claim Used for the Clinic Community Mental Health CenterInterim-First Claim Used for the
[Shared]763 Clinic Community Mental Health CenterInterim-Continuing Claims Clinic Community Mental Health CenterInterim-Continuing Claims Clinic Community Mental Health CenterInterim-Continuing Claims
[Shared]764 Clinic Community Mental Health CenterInterim-Last Claim Clinic Community Mental Health CenterInterim-Last Claim Clinic Community Mental Health CenterInterim-Last Claim
[Shared]765 Clinic Community Mental Health CenterLate Charge Only Clinic Community Mental Health CenterLate Charge Only Clinic Community Mental Health CenterLate Charge Only
[Shared]767 Clinic Community Mental Health CenterReplacement of Prior Claim Clinic Community Mental Health CenterReplacement of Prior Claim Clinic Community Mental Health CenterReplacement of Prior Claim
[Shared]768 Clinic Community Mental Health CenterVoid/Cancel of a Prior Claim Clinic Community Mental Health CenterVoid/Cancel of a Prior Claim Clinic Community Mental Health CenterVoid/Cancel of a Prior Claim
[Shared]769 Clinic Community Mental Health CenterFinal Claim for a Home Clinic Community Mental Health CenterFinal Claim for a Home Clinic Community Mental Health CenterFinal Claim for a Home
[Shared]791 Clinic OtherAdmit Through Discharge Clinic OtherAdmit Through Discharge Clinic OtherAdmit Through Discharge
[Shared]792 Clinic OtherInterim-First Claim Used for the Clinic OtherInterim-First Claim Used for the Clinic OtherInterim-First Claim Used for the
[Shared]793 Clinic OtherInterim-Continuing Claims Clinic OtherInterim-Continuing Claims Clinic OtherInterim-Continuing Claims
[Shared]794 Clinic OtherInterim-Last Claim Clinic OtherInterim-Last Claim Clinic OtherInterim-Last Claim
[Shared]795 Clinic OtherLate Charge Only Clinic OtherLate Charge Only Clinic OtherLate Charge Only
[Shared]797 Clinic OtherReplacement of Prior Claim Clinic OtherReplacement of Prior Claim Clinic OtherReplacement of Prior Claim
[Shared]798 Clinic OtherVoid/Cancel of a Prior Claim Clinic OtherVoid/Cancel of a Prior Claim Clinic OtherVoid/Cancel of a Prior Claim
[Shared]799 Clinic OtherFinal Claim for a Home Clinic OtherFinal Claim for a Home Clinic OtherFinal Claim for a Home
[Shared]811 Special Facility Hospice (Non Hospital Based)Admit Through Discharge Special Facility Hospice (Non Hospital Based)Admit Through Discharge Special Facility Hospice (Non Hospital Based)Admit Through Discharge
[Shared]812 Special Facility Hospice (Non Hospital Based)Interim-First Claim Used for the Special Facility Hospice (Non Hospital Based)Interim-First Claim Used for the Special Facility Hospice (Non Hospital Based)Interim-First Claim Used for the
[Shared]813 Special Facility Hospice (Non Hospital Based)Interim-Continuing Claims Special Facility Hospice (Non Hospital Based)Interim-Continuing Claims Special Facility Hospice (Non Hospital Based)Interim-Continuing Claims
[Shared]814 Special Facility Hospice (Non Hospital Based)Interim-Last Claim Special Facility Hospice (Non Hospital Based)Interim-Last Claim Special Facility Hospice (Non Hospital Based)Interim-Last Claim
[Shared]815 Special Facility Hospice (Non Hospital Based)Late Charge Only Special Facility Hospice (Non Hospital Based)Late Charge Only Special Facility Hospice (Non Hospital Based)Late Charge Only
[Shared]817 Special Facility Hospice (Non Hospital Based)Replacement of Prior Claim Special Facility Hospice (Non Hospital Based)Replacement of Prior Claim Special Facility Hospice (Non Hospital Based)Replacement of Prior Claim
[Shared]818 Special Facility Hospice (Non Hospital Based)Void/Cancel of a Prior Claim Special Facility Hospice (Non Hospital Based)Void/Cancel of a Prior Claim Special Facility Hospice (Non Hospital Based)Void/Cancel of a Prior Claim
[Shared]819 Special Facility Hospice (Non Hospital Based)Final Claim for a Home Special Facility Hospice (Non Hospital Based)Final Claim for a Home Special Facility Hospice (Non Hospital Based)Final Claim for a Home
[Shared]821 Special Facility Hospice (Hospital-Based)Admit Through Discharge Special Facility Hospice (Hospital-Based)Admit Through Discharge Special Facility Hospice (Hospital-Based)Admit Through Discharge
[Shared]822 Special Facility Hospice (Hospital-Based)Interim-First Claim Used for the Special Facility Hospice (Hospital-Based)Interim-First Claim Used for the Special Facility Hospice (Hospital-Based)Interim-First Claim Used for the
[Shared]823 Special Facility Hospice (Hospital-Based)Interim-Continuing Claims Special Facility Hospice (Hospital-Based)Interim-Continuing Claims Special Facility Hospice (Hospital-Based)Interim-Continuing Claims
[Shared]824 Special Facility Hospice (Hospital-Based)Interim-Last Claim Special Facility Hospice (Hospital-Based)Interim-Last Claim Special Facility Hospice (Hospital-Based)Interim-Last Claim
[Shared]825 Special Facility Hospice (Hospital-Based)Late Charge Only Special Facility Hospice (Hospital-Based)Late Charge Only Special Facility Hospice (Hospital-Based)Late Charge Only
[Shared]827 Special Facility Hospice (Hospital-Based)Replacement of Prior Claim Special Facility Hospice (Hospital-Based)Replacement of Prior Claim Special Facility Hospice (Hospital-Based)Replacement of Prior Claim
[Shared]828 Special Facility Hospice (Hospital-Based)Void/Cancel of a Prior Claim Special Facility Hospice (Hospital-Based)Void/Cancel of a Prior Claim Special Facility Hospice (Hospital-Based)Void/Cancel of a Prior Claim
[Shared]829 Special Facility Hospice (Hospital-Based)Final Claim for a Home Special Facility Hospice (Hospital-Based)Final Claim for a Home Special Facility Hospice (Hospital-Based)Final Claim for a Home
[Shared]831 Special Facility Ambulatory Surgery CenterAdmit Through Discharge Special Facility Ambulatory Surgery CenterAdmit Through Discharge Special Facility Ambulatory Surgery CenterAdmit Through Discharge
[Shared]832 Special Facility Ambulatory Surgery CenterInterim-First Claim Used for the Special Facility Ambulatory Surgery CenterInterim-First Claim Used for the Special Facility Ambulatory Surgery CenterInterim-First Claim Used for the
[Shared]833 Special Facility Ambulatory Surgery CenterInterim-Continuing Claims Special Facility Ambulatory Surgery CenterInterim-Continuing Claims Special Facility Ambulatory Surgery CenterInterim-Continuing Claims
[Shared]834 Special Facility Ambulatory Surgery CenterInterim-Last Claim Special Facility Ambulatory Surgery CenterInterim-Last Claim Special Facility Ambulatory Surgery CenterInterim-Last Claim
[Shared]835 Special Facility Ambulatory Surgery CenterLate Charge Only Special Facility Ambulatory Surgery CenterLate Charge Only Special Facility Ambulatory Surgery CenterLate Charge Only
[Shared]837 Special Facility Ambulatory Surgery CenterReplacement of Prior Claim Special Facility Ambulatory Surgery CenterReplacement of Prior Claim Special Facility Ambulatory Surgery CenterReplacement of Prior Claim
[Shared]838 Special Facility Ambulatory Surgery CenterVoid/Cancel of a Prior Claim Special Facility Ambulatory Surgery CenterVoid/Cancel of a Prior Claim Special Facility Ambulatory Surgery CenterVoid/Cancel of a Prior Claim
[Shared]839 Special Facility Ambulatory Surgery CenterFinal Claim for a Home Special Facility Ambulatory Surgery CenterFinal Claim for a Home Special Facility Ambulatory Surgery CenterFinal Claim for a Home
[Shared]841 Special Facility Free Standing Birthing CenterAdmit Through Discharge Special Facility Free Standing Birthing CenterAdmit Through Discharge Special Facility Free Standing Birthing CenterAdmit Through Discharge
[Shared]842 Special Facility Free Standing Birthing CenterInterim-First Claim Used for the Special Facility Free Standing Birthing CenterInterim-First Claim Used for the Special Facility Free Standing Birthing CenterInterim-First Claim Used for the
[Shared]843 Special Facility Free Standing Birthing CenterInterim-Continuing Claims Special Facility Free Standing Birthing CenterInterim-Continuing Claims Special Facility Free Standing Birthing CenterInterim-Continuing Claims
[Shared]844 Special Facility Free Standing Birthing CenterInterim-Last Claim Special Facility Free Standing Birthing CenterInterim-Last Claim Special Facility Free Standing Birthing CenterInterim-Last Claim
[Shared]845 Special Facility Free Standing Birthing CenterLate Charge Only Special Facility Free Standing Birthing CenterLate Charge Only Special Facility Free Standing Birthing CenterLate Charge Only
[Shared]847 Special Facility Free Standing Birthing CenterReplacement of Prior Claim Special Facility Free Standing Birthing CenterReplacement of Prior Claim Special Facility Free Standing Birthing CenterReplacement of Prior Claim
[Shared]848 Special Facility Free Standing Birthing CenterVoid/Cancel of a Prior Claim Special Facility Free Standing Birthing CenterVoid/Cancel of a Prior Claim Special Facility Free Standing Birthing CenterVoid/Cancel of a Prior Claim
[Shared]849 Special Facility Free Standing Birthing CenterFinal Claim for a Home Special Facility Free Standing Birthing CenterFinal Claim for a Home Special Facility Free Standing Birthing CenterFinal Claim for a Home
[Shared]891 Special Facility OtherAdmit Through Discharge Special Facility OtherAdmit Through Discharge Special Facility OtherAdmit Through Discharge
[Shared]892 Special Facility OtherInterim-First Claim Used for the Special Facility OtherInterim-First Claim Used for the Special Facility OtherInterim-First Claim Used for the
[Shared]893 Special Facility OtherInterim-Continuing Claims Special Facility OtherInterim-Continuing Claims Special Facility OtherInterim-Continuing Claims
[Shared]894 Special Facility OtherInterim-Last Claim Special Facility OtherInterim-Last Claim Special Facility OtherInterim-Last Claim
[Shared]895 Special Facility OtherLate Charge Only Special Facility OtherLate Charge Only Special Facility OtherLate Charge Only
[Shared]897 Special Facility OtherReplacement of Prior Claim Special Facility OtherReplacement of Prior Claim Special Facility OtherReplacement of Prior Claim
[Shared]898 Special Facility OtherVoid/Cancel of a Prior Claim Special Facility OtherVoid/Cancel of a Prior Claim Special Facility OtherVoid/Cancel of a Prior Claim
[Shared]899 Special Facility OtherFinal Claim for a Home Special Facility OtherFinal Claim for a Home Special Facility OtherFinal Claim for a Home
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