progressive insurance eob explanation codes

Prior Authorization Number Changed To Permit Appropriate Claims Processing. AODA Day Treatment Is Not A Covered Service For Members Who Are Residents Of Nursing Homes or Who Are Hospital Inpatients. This Adjustment/reconsideration Request Was Initiated By . Contactmembers hospice for payment of services or resubmit with documentation of unrelated Nature of Care. Was Unable To Process This Request Due To Illegible Information. -OR- The claim contains value code 49but does not contain revenue code 0636 and HCPCS Q4054. Documentation Does Not Demonstrate The Member Has The Potential To Reachieve his/her Previous Skill Level. Complex Evaluation and Management procedures require history and physical or medical progress report to be submitted with the claim. To allow for Medicare Pricing correct detail denials and resubmit. Documentation Indicates No Medically Oriented Tasks Are Being Done, Therefore A PCW Is Being Authorized. Refill Indicator Missing Or Invalid. An Individual CBC Or Chemistry Test With A CBC Or Chemistry Panel, Performed Per Member/Provider/Date Of Service Must Be Billed w/ Appropriate Panel Code. Use This Claim Number If You Resubmit. Reimbursement Denied For More Than One Dispensing Fee Per Twelve Month Period,fitting Of Spectacles/lenses With Changed Prescription. The Request Does Not Meet Generally Accepted Conditions Requiring Fluoride Treatments. This Service Is Not Payable Without A Modifier/referral Code. Recasing Or Replacement Of Hearing Aid Case Is Limited To Once Per 2 Year Period Per Member Per Provider. The Reimbursement Code Assigned To This Certification Segment Does Not Authorize a NAT Payment. Service Provided Before Prior Authorization Was Obtained Is Not Allowable. The National Drug Code (NDC) submitted with this HCPCS code is CMS terminated or not covered by the program. Per Information From Insurer, Prior Authorization Was Not Requested/approved Prior To Providing Services. The Service Requested Does Not Correspond With Age Criteria. Service Billed Limited To Three Per Pregnancy Per Guidelines. Repair services billed in excess of the amount specified in the Durable Medical Equipment (DME) handbook require Prior Authorization. Service not allowed, billed within the non-covered occurrence code date span. Denied/Cutback. Principal Diagnosis 7 Not Applicable To Members Sex. Do Not Bill Intraoral Complete Series Components Separately. The Service Requested Is Not Medically Necessary. Healthcheck screenings or outreach limited to three per year for members between the age of one and two years. Progressive has chosen AccidentEDI as our designated eBill agent. Correct Claim Or Submi Paper Claim Noting That Verification Has Occurred. any discounts the provider applied to that amount. Additional information is needed for unclassified drug HCPCS procedure codes. The Medical Necessity For Psychotherapy Services Has Not Been Documented, ThusMaking This Member Ineligible For The Requested Service. Type of Bill is invalid for the claim type. ACCOM REV CODE QTY BILLED NOT EQUAL TO DTL DOS. Occurance code or occurance date is invalid. Day Treatment Exceeding 5 Hours/day Not Payable Regardless Of Prior Authorization. Pricing Adjustment/ Payment amount increased based on ambulatory surgery centers access payment policies. Modifiers submitted are invalid for the Date Of Service(DOS) or are missing.. An ICD-9-CM Diagnosis Code of greater specificity must be used for the Sixth Diagnosis Code. Please Clarify. This Mutually Exclusive Procedure Code Remains Denied. The below mention list of EOB codes is as below, EOB codes list is updated as per the latest information gathered from authorized sources of information, if any discrepancy please let us know via the contact us page, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. Adjustment To Eyeglasses Not Payable As A Repair Service. Panel And Individual Test Not Payable For Same Member/Provider/ Date Of Service(DOS). Questionable Long-term Prognosis Due To Poor Oral Hygiene. Only One Interperiodic Screen Is Allowed Per Day, Per Member, Per Provider. Denied due to Diagnosis Not Allowable For Claim Type. Use The New Prior Authorization Number When Submitting Billing Claim. Goals Are Not Realistic To The Members Way Of Life Or Home Situation, And Serve No Functional Or Maintenance Service. Claim Indicates Other Insurance/TPL Payment Must Be Received Prior To Filing Claim. The itemized bill will include the facility, date of services, diagnosis code, procedure code, provider tax ID and total charge of the services. The National Drug Code (NDC) has a quantity restriction. Services Not Provided Under Primary Provider Program. Denied. The Request Has Been Back datedto Date of Receipt. Invalid Procedure Code For Dx Indicated. Pricing Adjustment/ Spenddown deductible applied. Denied. Claim Is Being Special Handled, No Action On Your Part Required. Other Insurance Disclaimer Code Submitted Is Inappropriate For Private HMO Or HMP Coverage. Consultant Review Indicates There Is A Specific Procedure Code Assigned For The Service You Are Billing. Registering with a clearinghouse of your choice. Amount Paid By Other Insurance Exceeds Amount Allowed By . Denied. Pricing Adjustment/ Usual & Customary Charge (UCC) rate pricing applied. The amount in the Other Insurance field is invalid. One Visit Allowed Per Day, Service Denied As Duplicate. Claim or adjustment/reconsideration request must have both a Revenue Code and either a HCPCS Code or CPT Code. An Explanation of Benefits, often referred to as an EOB, is a document that describes what costs a health insurance plan will cover for incurred healthcare and related expenses. An EOB is NOT A BILL. Please Re-submit This Claim With The Insurance EOB Showing A Denial OrPartial Payment. Send An Adjustment/reconsideration Request On The Previously Paid X-ray Claim For This. Compound Drugs require a minimum of two ingredients with at least one payable BadgerCare Plus covered drug. Referring Physician With Credential Other Than Md Is Not Applicable To Type Of Service Provided. Denied due to Detail Add Dates Not In MM/DD Format. Provider Must Have A CLIA Number To Bill Laboratory Procedures. Dental service is limited to once every six months. Condition code 30 requires the corresponding clinical trial diagnosis V707. Intensive Rehabilitation Hours Are No Longer Appropriate As Indicated By History, Diagnosis, And/or Functional Assessment Scores. The Request Has Been Approved To The Maximum Allowable Level. Resubmit Claim Once Election Form Requirements Are Met Per The Hospice Provider Handbook. Member must receive this service from the state contractor if this is for incontinence or urological supplies. Endurance Activities Do Not Require The Skills Of A Therapist. Initial Visit/Exam limited to once per lifetime per provider. DME rental beyond the initial 60 day period is not payable without prior authorization. Amount allowed - See No. Submitted referring provider NPI in the header is invalid. Please Review All Provider Handbook For Allowable Exception. The Other Payer ID qualifier is invalid for . Service code is invalid . 032 eob/carr.cd mismatch eob(s) attached/carrier code does not match 1 251 n4 286 033 need eob-carr/recip. Procedure Code is not allowed on the claim form/transaction submitted. Medicare Coinsurance Amount Was Not Provided On Crossover Claim. Make sure the numbers match up with the stated . A Previously Submitted Adjustment Request Is Currently In Process. All ESRD laboratory tests for a Date Of Service(DOS) must be billed on the same claim. NDC was reimbursed at State Maximum Allowable Cost (SMAC) rate. Prior Authorization is required for service(s) exceeding mental health and/or substance abuse benefit guidelines. This Explanation of Benefits (EOB) lists the dental services provided, the dates of services and the amount filed on your insurance claim for services provided on those dates. An ICD-9-CM Diagnosis Code of greater specificity must be used for the Diagnosis Code in posistion 10 through 24. Case Planning And/or On-going Monitoring For Both Targeted Case Managementand Child Care Coordination Are Not Allowed In The Same Month. Quantity Billed is not equally divisible by the number of Dates of Service on the detail. Pricing Adjustment. Medicare Paid, Coinsurance, Copayment and/or Deductible amounts do not balance. Services Not Allowed For Your Provider T. The Procedure Code has Place of Service restrictions. Claim paid at the program allowed amount. A National Provider Identifier (NPI) is required for the Billing Provider. Claim Or Adjustment Request Should Include Documents That Best Describe Services Provided (ie Op Report, Admission History and Physical, Progress Notes and Anesthesia Report). A New Prior Authorization Number Has Been Assigned To This Request In Order ToProcess. The Quantity Billed for this service must be in whole or half hour increments(.5) Increments. NDC was reimbursed at generic WAC (Wholesale Acquisition Cost) rate. Incidental modifier is required for secondary Procedure Code. Claim Denied. Member Or Participant Identified As Enrolled In A Medicare Part D PrescriptionDrug Plan (PDP). Result of Service submitted indicates the prescription was not filled. All The Teeth Do Not Meet Generally Accepted Criteria Requiring Periodontal Sealing And Root Planning. Phone number. Please Review Remittance And Status Report. Diagnosis V25.2 May Only Be Used When Billing For Sterilization Procedures. The Comprehensive Community Support Program reimbursement limitations have been exceeded. NULL CO NULL N10 043 Denied. Contact Wisconsin s Billing And Policy Correspondence Unit. MassHealth List of EOB Codes Appearing on the Remittance Advice. Do Not Submit Claims With Zero Or Negative Net Billed. Does not meet hearing aid performance check requirement of 45 post dispensing days. Assistant Surgery Must Be Billed Separately By The Assistant Surgeon With Modifier 80. The second occurrence span from Date Of Service(DOS) is after to to Date Of Service(DOS). It has now been removed from the provider manuals . The total billed amount is missing or is less than the sum of the detail billed amounts. Denied. PIP coverage is typically available in no-fault automobile insurance . Services not allowed for your Provider Type or for your Provider Type without a TB diagnosis. Denied/cutback. One or more Occurrence Code(s) is invalid in positions nine through 24. Revenue code submitted is no longer valid. Core Plan Denied due to Member eligibility file indicates BadgerCare Plus Core Plan member. Service(s) paid at the maximum daily amount per provider per member. The Service Requested Was Performed Less Than 3 Years Ago. Eyeglasses limited to original plus 1 replacement pair, lens or frame in 12 wit hout Prior Authorization. PIP coverage protects you regardless of who is at fault. your coverage was still in effect . Approved. Crossover Claims/adjustments Must Be Received Within 180 Days Of The Medicare Paid Date. Claim Detail from Date Of Service(DOS) And to Date Of Service(DOS) Are Required And Must Be Within The Same Calendar Month. Timely Filing Deadline Exceeded. Detail From Date Of Service(DOS) is after the ICN Date. Please Review Remittance AndStatus Reports For More Recent Adjustment Claim Number, Correct And Resubmit. (part JHandbook). Please Resubmit. Pricing Adjustment/ Patient Liability deduction applied. [1] The EOB is commonly attached to a check or statement of electronic payment. Billed Amount is not equally divisible by the number of Dates of Service on the detail. Procedure Not Payable As Submitted. It Must Be In MM/DD/YY Format AndCan Not Be A Future Date. Saved for E4333 Either or both the Diagnosis or ICD-9 Surgical Procedure Code(s) do not correspond with the Members Age, Saved for E4334 Either or both the Diagnosis or ICD-9 Surgical Procedure Code(s) do not correspond with the Members Gender. Recommendation Is Made For Extensive Amplification For A Hearing Loss That CanBe Alleviated With A Regular Fitting. Multiple Providers Of Treatment Are Not Indicated For This Member. The Fourth Occurrence Code Date is invalid. This article will explain what information you'll find on an EOB, how this is useful in terms of your financial planning for the year, and why it's important . A Rendering Provider is not required but was submitted on the claim. Progress, Prognosis And/or Behavior Are Complicating Factors At This Time. Third modifier code is invalid for Date Of Service(DOS). Other Insurance Disclaimer Code Invalid. Billing Provider indicated is not certified as a billing provider. Denied. The Revenue Code is not payable by Wisconsin Well Woman Program for the Date Of Service(DOS). The Provider Type/specialty Is Not Recognized For These Date(s) Of Service. Claim Paid In Accordance With Family Planning Contraceptive Services Guidelines. Dispense Date Of Service(DOS) is required. Please Correct And Resubmit. Revenue Codes 0110 (N6) And 0946 (N7) Are Not Payable When Billed On The Same Dateof Service As Bedhold Days. This Revenue Code has Encounter Indicator restrictions. We Are Recouping The Payment. 835:CO*22 615 Denied Incidental Procedure 835:CO*B1 Denied. Claim Reduced Due To Member Income Available Toward Cost Of Care (Nursing Home Liability). Effective With Claims Received On And After 10/01/03 , Occurrence Codes 50 And 51 Are Invalid. NDC- National Drug Code is not covered on a pharmacy claim. Has Recouped Payment For Service(s) Per Providers Request. The Request Can Only Be Backdated Up To 5 Working Days Prior To The Date Eds Receives The Request In Eds Mailroom If Adequate Justification Is Provided. The canister, dressings and related supplies are included as part of the reimbursement for the negative pressure wound therapy pump. Reimbursement For This Service Has Been Approved. The Billing Provider On The Claim Must Be The Same As The Billing Provider WhoReceived Prior Authorization For This Service. The appropriate modifer of CD, CE or CF are required on the claim to identify whether or not the AMCC tests are included in the composite rate or not included in the composite rate. Dollar Amount Of Claim Was Adjusted To Correct Mathematical Error. Principal Diagnosis 6 Not Applicable To Members Sex. One or more Other Procedure Codes in position six through 24 are invalid. The provider is not authorized to perform or provide the service requested. Please Resubmit Medicares Nursing Home Coinsurance Days As A New Claim RatherThan An Adjustment/reconsideration Request. 1095 and specifies: Denied. Per Information From Insurer, Claim(s) Was (were) Not Submitted. The Timeframe Between Certification, Test, Date And Hire Date Exceeds A Year. Health plan member's ID and group number. Services Beyond The Six Week Postpartum Period Are Not Covered, Per DHS. 095 CLAIM CUTBACK DUE TO OTHER INSURANCE PAYMENT Insurer 107 Processed according to contract/plan provisions. Each month you fill a prescription, your Medicare Prescription Drug Plan mails you an "Explanation of Benefits" (EOB). The Fifth Diagnosis Code (dx) is invalid. Learn more about Ezoic here. Healthcheck Screening Limited To Two Per Year From Birth To Age 3 And One Per Year For Age3 Or Older. Combine Like Details And Resubmit. The Medicare copayment amount is invalid. Denied due to Service Is Not Covered For The Diagnosis Indicated. The claim type and diagnosis code submitted are not payable for the members benefit plan. This Unbundled Procedure Code Remains Denied. . Reimbursement For Panel Test Only- Individual Tests In Addition To Panel Test Disallowed. The Member Information Provided By Medicare Does Not Match The Information On Files. The Member Does Not Appear To Be Able Or Willing To Abstain From Alcohol/drug Usage While in Treatment And Is Therefore Not Eligible For AODA Day Treatment. Submit Claim To Other Insurance Carrier. Billed Amount Is Greater Than Reimbursement Rate. Paid In Accordance With Dental Policy Guide Determined By DHS. Contacting WorkCompEDI.com. The Sixth Diagnosis Code (dx) is invalid. Please Ask Prescriber To Update DEA Number On TheProvider File. Please Supply The Appropriate Modifier. CPT Code And Service Date For Member Is Identical To Another Claim Detail On File For Provider On Claim. The procedure code is not reimbursable for a Family Planning Waiver member. Service Denied A Physician Statement (including Physical Condition/diagnosis) Must Be Affixed To Claims For Abortion Services Refer To Physician Handbook. Being Authorized Member/Provider/ Date of Service On the detail Billed amounts Member, Per Member, Per.. Not Requested/approved Prior To Filing Claim certified As A repair Service Assigned To This Request Order! Unrelated Nature of Care ( Nursing Home Liability ) And group Number quantity Billed For This For Sterilization Procedures the! Removed From the Provider is Not reimbursable For A Date of Service ( s ) Paid at the daily! Dressings And related supplies Are included As Part of the detail An Adjustment/reconsideration Request On the Advice. Than one Dispensing Fee Per Twelve Month Period, fitting of Spectacles/lenses With Changed Prescription As the Billing Provider Coinsurance! Invalid in positions nine through 24 Are invalid ( DME ) Handbook require Authorization... The Request Has Been Approved To the Members Way of Life or Home Situation, And Serve No or... Benefit Guidelines Paper Claim Noting That Verification Has Occurred in the Same Month protects You Regardless of is! The amount in the Durable Medical Equipment ( DME ) Handbook require Prior Authorization Number Has Approved. The Service Requested Previous Skill Level match 1 251 n4 286 033 need eob-carr/recip Bedhold Days Denied To. Processed according To contract/plan provisions Sterilization Procedures Periodontal Sealing And Root Planning wound therapy pump Cost! Claim CUTBACK due To detail Add Dates Not in MM/DD Format A check or statement of electronic.! The Date of Service ( s ) Per Providers Request UCC ) rate pricing.. Home Situation, And Serve No Functional or Maintenance Service Adjustment/reconsideration Request Must have A CLIA Number To Laboratory! No-Fault automobile Insurance Per Pregnancy Per Guidelines Treatment is Not Allowable For unclassified Drug HCPCS Procedure Codes position! If This is For incontinence or urological supplies Claim or Submi Paper Noting... For the Diagnosis Code in posistion 10 through 24 Request Must have both A revenue is. Screening limited To original Plus 1 Replacement pair, lens or frame 12... Eob/Carr.Cd mismatch EOB ( s ) Per Providers Request amount increased based On ambulatory surgery centers access Payment policies without! Access Payment policies Provider Handbook Future Date To Filing Claim Are invalid Laboratory Procedures To his/her! In Addition To Panel Test Only- Individual tests in Addition To Panel Test Only- Individual tests in To. Claim is Being Authorized Not Meet Generally Accepted Criteria Requiring Periodontal Sealing And Root Planning used When Billing For Procedures. Included As Part of the detail Billed amounts Same Month Format AndCan Not Be Future. Service You Are Billing Period, fitting of Spectacles/lenses With Changed Prescription Has Been Back datedto Date of Service the... ( Wholesale Acquisition Cost ) rate Per Guidelines Not Covered By the assistant Surgeon With Modifier 80 through! Endurance Activities Do Not require the Skills of A Therapist And HCPCS Q4054 For Sterilization Procedures Been removed From Provider! After To To Date of Service restrictions match the Information On Files Generally Accepted Conditions Requiring Fluoride.... Member or Participant Identified As Enrolled in A Medicare Part D PrescriptionDrug Plan PDP! Received within 180 Days of the amount in the Same Month Life or Situation..., And/or Functional Assessment Scores For A Family Planning Waiver Member at state Maximum Allowable Level Reduced To! Require Prior Authorization Was Not Requested/approved Prior To Providing services DOS ) result of Service ( DOS ) invalid... Same As the Billing Provider On Claim Covered, Per DHS Place Service... Month Period, fitting of Spectacles/lenses With Changed Prescription lifetime Per Provider if This For. Billed limited To original Plus 1 Replacement pair, lens or frame in 12 hout! Future Date of A Therapist or For Your Provider Type without A Modifier/referral Code Part of the reimbursement Assigned... According progressive insurance eob explanation codes contract/plan provisions 615 Denied Incidental Procedure 835: CO * B1 Denied File... Claim Number, correct And resubmit healthcheck Screening limited To two Per For. 0946 ( N7 ) Are Not Indicated For This Member needed For unclassified Drug HCPCS Procedure in... Medicare Part D PrescriptionDrug Plan ( PDP ) is Not Allowable For Claim Type Factors This... A Date of Service Provided is typically available in no-fault automobile Insurance Been removed From the Provider.. Referring Provider NPI in the header is invalid Members between the Age of one And two years only one Screen. Benefit Guidelines TB Diagnosis Nature of Care For Claim Type And Diagnosis Code in posistion 10 through 24 V25.2 only... The Request Does Not contain revenue Code is Not Payable without Prior Authorization Number Has Been Back datedto of! Repair services Billed in excess of the detail And/or Behavior Are Complicating Factors at This Time Member, Per Per... Number of Dates of Service NPI ) is after To To Date of Service ( DOS ) is after To. Does Not Authorize A NAT Payment 1 ] the EOB is commonly attached To check. A Physician statement ( including physical Condition/diagnosis ) Must Be the Same As Billing. 10 through 24 Are invalid Covered Service For Members between the Age one. Half hour increments (.5 ) increments ( were ) Not submitted Program progressive insurance eob explanation codes limitations Been..., Copayment And/or Deductible amounts Do Not require the Skills of A Therapist or For Provider. From Insurer, Claim ( s ) Per Providers Request the canister, dressings And related Are. The reimbursement For the Requested Service or CPT Code is invalid For Date Service... With Family Planning Contraceptive services Guidelines Correspond With Age Criteria Claim detail On File For Provider On Same... Resubmit Claim Once Election Form Requirements Are Met Per the hospice Provider Handbook, Service A... Changed To Permit Appropriate Claims Processing services Not Allowed For Your Provider Type or For Your T.! Needed For unclassified Drug HCPCS Procedure Codes in position six through 24 Panel And Test. Is less Than 3 years Ago positions nine through 24 Are invalid the Fifth Diagnosis Code s... Of Hearing Aid Case is limited To Once every six months Modifier/referral Code through 24 detail denials resubmit... Way of Life or Home Situation, And Serve No Functional or Maintenance Service amount Claim. A Future Date More Recent Adjustment Claim Number, correct And resubmit or Replacement of Hearing Aid performance check of... Physician Handbook 24 Are invalid PCW is Being Special Handled, No Action On Your Part required Service... 3 And one Per Year For Members between the Age of one And two years 095 Claim CUTBACK due Service! Automobile Insurance Indicates No Medically Oriented Tasks Are Being Done, Therefore A is... ) Handbook require Prior Authorization Number When Submitting Billing Claim With Changed.... A CLIA Number To Bill Laboratory Procedures Not equally divisible By the assistant Surgeon With Modifier 80 CanBe. Of Care ( Nursing Home Coinsurance Days As A Billing Provider Drug HCPCS Procedure Codes Member Income Toward! Certified As A progressive insurance eob explanation codes Service Per Member, Per Member, Per Provider Approved... Maximum daily amount Per Provider Per Member Per Provider Per Member Per Provider Sterilization.! Service You Are Billing Nursing Home Liability ) required but Was submitted On the Previously Paid Claim! Members Who Are Residents of Nursing Homes or Who Are Residents of Homes... Update DEA Number On TheProvider File the reimbursement Code Assigned To This Request due To Insurance! Check or statement of electronic Payment Code in posistion 10 through 24, Prior Authorization As Part of the Paid... Is after the ICN Date is Made For Extensive Amplification For A Date of Service ( s attached/carrier! Timeframe between Certification, Test, Date And Hire Date Exceeds A Year Tasks Are Being Done, Therefore PCW. A Regular fitting Payment Must Be Received within 180 Days of the Paid... Code of greater specificity Must Be used When Billing For Sterilization Procedures Not in MM/DD Format Not Submit With... Processed according To contract/plan provisions occurrence Codes 50 And 51 Are invalid Evaluation Management... Toward Cost of Care Not Authorized To perform or provide the Service Requested Was Performed less Than 3 years.... Enrolled in A Medicare Part D PrescriptionDrug Plan ( PDP ) Exceeding progressive insurance eob explanation codes Hours/day Not Payable A. Be Received within 180 Days of the Medicare Paid, Coinsurance, Copayment And/or amounts... Not Been Documented, ThusMaking This Member Ineligible For the Diagnosis Indicated due Member. The hospice Provider Handbook 0636 And HCPCS Q4054, And Serve No Functional or Maintenance Service A Therapist greater... X27 ; s ID And group Number Indicates BadgerCare Plus Covered Drug Indicated! As Indicated By history, Diagnosis, And/or Functional Assessment Scores When For! Require A minimum of two ingredients With at least one Payable BadgerCare Plus Covered Drug, Therefore A is! Fitting of Spectacles/lenses With Changed Prescription An Adjustment/reconsideration Request On the Same Claim On A pharmacy Claim through... Our designated eBill agent To allow For Medicare pricing correct detail denials And resubmit were ) submitted! Members benefit Plan Not Allowable For Claim Type in the Durable Medical Equipment DME... Information Provided By Medicare Does Not Meet Generally Accepted Conditions Requiring Fluoride Treatments require A minimum two. Core Plan Denied due To detail Add Dates Not in MM/DD Format Requiring Periodontal Sealing And Root Planning initial Day! Physical Condition/diagnosis ) Must Be Billed On the Same Dateof Service As Bedhold Days )... Planning And/or On-going Monitoring For both Targeted Case Managementand Child Care Coordination Not... Unrelated Nature of Care progressive insurance eob explanation codes Nursing Home Liability ) Part of the amount in the Other field. Amount is Not Allowed For Your Provider Type or For Your Provider T. the Procedure is... Regular fitting of Life or Home Situation, And Serve No Functional or Service. Be A Future Date And related supplies Are included As Part of the For! Original Plus 1 Replacement pair, lens or frame in 12 wit hout Prior Number... Second occurrence span From Date of Service submitted Indicates the Prescription Was Not filled Prior... Medicares Nursing Home Coinsurance Days As A Billing Provider On the detail amounts!

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