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If you don't
know what you are doing ,
DON'T USE
THIS APPLICATION !
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Use your <TAB>
key to move down the fields.
DO NOT Use the <ENTER KEY>
UNTIL DONE.
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| PRIMARY INSURANCE CARRIER INFORMATION |
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| SECONDARY INSURANCE CARRIER INFORMATION |
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| PATIENT DIAGNOSIS INFORMATION |
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examples:
01-15-2001
- drainable ostomy bags Holl. #4454 - 30 ea - $84.50
03-07-07
- IAPRAT - 300ml - 13.20
03-07-07
- 100 LANCETS - (
if no money is entered we will use fee schedule amount )
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