Effective 10/16/2003, Other Assessments or Allowances (e.g., Medical Education) Payer A, The amount of other assessments or allowances (e.g., medical education) pertaining to the indicated payer. This value or value 58 is required on the initial bill for oxygen therapy and on fourth month’s bill. The field contains one numeric digit. (Effective 1/01/05), Regulatory Surcharges, Assessments, Allowances or Health Care Related Taxes Payer A, The amount of regulatory surcharges, assessments, allowances or health care related taxes pertaining to the indicated payer. Offset to the Patient-Payment Amount – Chiropractic Services. $1,861.50 $16.00. xref f� ���@� �m�e����^i.���i��#r�nce`��"�� � ��*J The provider reports in whole units to the left of the dollar/cent delimiter. Medicare uses this information in internal processes and also in the CMS notice of utilization sent to the patient to explain that Part B coinsurance applies to the professional component. ASCII Codes - Table for easy reference of ascii characters and symbols, with conversion tables and HTML codes Color conversion. Decimals (i.e. For demonstration claims this will be a fixed copayment unique to each hospital and DRG (or DRG/procedure group). The number of hours of peritoneal dialysis provided during the billing period. (For third party payer use only.) The number of visits determined by Medicare to be payable from the Part A trust fund to reflect the shift of payments from the Part A to the Part B Trust Fund as mandated by §1812(a)(3) of the Social Security Act. (For internal use by third party payers only.). For outpatient claims, these charges are excluded in determining the deductible and coinsurance due from the patient to avoid duplication when the carrier processes the bill for physician’s services. For patients just starting, use the most recent value prior to the onset of treatment. The FI approved the provider charging the beneficiary the amount shown for non-covered accommodations, diagnostic procedures, or treatments. FL 39-41 Value Codes and Amounts 38 FL 42 Revenue Codes 42 FL 43 National Drug Code (NDC) Reporting 43 ... 50 FL 67 Principal Diagnosis Code and Present on Admission Indicator 51 FL 67 a-q Other Diagnosis Codes 51 FL 68 Reserved for Assignment by NUBC 52 FL 69 Admitting Diagnosis 52 FL 70 a-q Patient‟s Reason for Visit Code 52 0000001278 00000 n This is the amount of Part B coinsurance applied by the intermediary to this claim. Hospitals do not report value code 68 for units of EPO. Disclaimer. Today's top Value City Furniture promotion: Additional 50% Off Richard Ginori Dinnerware. x�bb``b``� � o\ � Get Code 18. 0000002880 00000 n That portion from a higher priority liability insurance paid on behalf of a Medicare beneficiary that the provider is applying to Medicare covered charges on this bill. Adjudged Value on Westlaw. No deductible or coinsurance has been applied. For use with Revenue Code 0637. For newborns, use Value Code 54. That portion of a higher priority WC insurance payment made on behalf of a Medicare beneficiary that the provider is applying to covered Medicare charges on this bill. NOTE: Codes 58 and 59 are not money amounts. For Part B coinsurance use value codes A2, B2 and C2. H�t�Qo�0���)��LűM U��d�2�Sx��=��4�2����{gB�=4��������ɪ>��]�������q�Z�������_6����ܱi��RA��S�,A�@�a�$�f� J�/R�Wl��$,��}}D�}�&酮F�Ȟd!+��\CB���U����hW(}A-�wT-����k��3]�$>���tk%f�����3s�H��C(� Medicare Lifetime Reserve Amount in the Second Calendar Year in Billing Period. using Process A. EFFECTIVE DATE: October 1, 2010. Report the whole number right justified to the left of the dollar/cents delimiter and fractional amounts to the right. Report this data only when the health plan has a predefined change in reimbursement that is affected by height. ), Indicates oxygen saturation at the beginning of each reporting period for oxygen therapy. The number of visits determined by Medicare to be payable from the Part B trust fund to reflect the shift of payments from the Part A to the Part B Trust Fund as mandated by §1812(a)(3) of the Social Security Act. These charges are also deducted when computing interim payment. The product of the number of lifetime reserve days used in the first calendar year of the billing period times the applicable lifetime reserve coinsurance rate. Medicare Part A and Part B Blood Deductible. (The HHA reports the MSA when its branch location is different than the HHA’s main location – It reports the MSA number in dollar portion of the form locator, right justified to the left of the dollar/cents delimiter. Disabled Beneficiary Under Age 65 With LGHP. Used to identify the It does not include any capital outlier payment in this entry. Amount Provider Agreed to Accept From Primary Payer When this Amount is Less than Charges but Higher than Payment Received. It must also report condition codes 04 and 78.). 50: 50: 50: dark gray: 120: 120: 120: medium gray: 200: 200: 200: light gray: 250: 200: 200: ... we'll write code to fix this image by copying the red value over to be used as the green and blue value. True Value Coupon Codes. Entries for the number of visits are right justified from the dollars/cents delimiter: Indicates arterial blood gas value at the beginning of each reporting period for oxygen therapy. If arrangements have been made for replacement, pints are shown as replaced. Codes reserved for internal use only by third party payers. Saving money with our Match.com Discount Code has never been easier! The most recent hematocrit reading taken before the start of this billing period. Entering this code requires $0.00 amount. 39 -41 Situational Value Codes: Enter 2 -digit value code and dollar amount or number of days. Please click on the cover images below to either learn more about the publication or, … Covered Self-Administrable Drugs – Emergency. 50%. FindLaw Codes are provided courtesy of Thomson Reuters Westlaw, the industry-leading online legal research system. Payments for operating IME and DSH which are processed in the traditional manner are also not included in this amount. 37 Unlabeled Leave Blank. 0000006972 00000 n Skilled Nurse – Home Visit Hours (HHA only), The number of hours of skilled nursing provided during the billing period. OFF. That portion of a higher priority EGHP payment made on behalf of an aged beneficiary that the provider is applying to covered Medicare charges on this bill. (Applies to Part B bills only.) That portion of a higher priority LGHP payment made on behalf of a disabled beneficiary that it is applying to covered Medicare charges on this bill. GENERAL INFORMATION . (Used only by some all-inclusive rate hospitals. 50p Coin Prices. This should include the prospective DRG payment (both capital as well as operational) as well as any outlier payment, which would be applicable. Effective 10/16/03, Other Assessments or Allowances (e.g., Medical Education) Payer B, The amount of other assessments or allowances (e.g., medical education) pertaining to the indicated, The amount the provider assumes will be applied to the patient’s deductible amount involving the indicated payer. This amount is instead of the traditional prospective DRG payment (operating and capital) as well as any outlier payments that might have been applicable in the absence of the demonstration. Supports resistors with 3, 4, 5 and 6 bands. MSA number or Core Based Statistical Area (CBSA) number (or rural State code) of the location where the home health or hospice service is delivered. In such cases, all blood charges are shown under the 039X revenue code series (blood administration) or under the 030X revenue code series (laboratory). endstream endobj 86 0 obj <>/Metadata 20 0 R/PieceInfo<>>>/Pages 19 0 R/PageLayout/OneColumn/StructTreeRoot 22 0 R/Type/Catalog/Lang(�� E N - U S)/LastModified(D:20121130174517)/PageLabels 17 0 R>> endobj 87 0 obj <>/ColorSpace<>/Font<>/ProcSet[/PDF/Text/ImageC]/ExtGState<>>>/Type/Page>> endobj 88 0 obj <> endobj 89 0 obj <> endobj 90 0 obj [/ICCBased 105 0 R] endobj 91 0 obj <> endobj 92 0 obj <> endobj 93 0 obj <>stream It enters six zeros (0000.00) in the amount field if it is claiming a conditional payment because the EGHP has denied coverage. Working Aged Beneficiary Spouse With an EGHP. 0000043182 00000 n Actual birth weight or weight at time of admission for an extramural birth. It enters six zeros (0000.00) in the amount field if it is claiming a conditional payment because there has been a substantial delay in the other payer’s payment. It enters six zeros (0000.00) in the amount field to claim a conditional payment because the EGHP has denied coverage. The hour when the accident occurred that necessitated medical treatment. The dollar amounts determined to be associated with the HH visits identified in a value code 63 amount. The CMS assigns as needed. Indicates arterial blood gas value at the beginning of each reporting period for oxygen therapy. The New Nebraska Energy Code -- 2003 International Energy Conservation Code; ... R-19 batts compressed into a nominal 2x6 framing cavity such that the R-value is reduced by R-1 or more shall be marked with the compressed batt R-value in addition to the full thickness R-value. 35-36 Occurrence Spans (Code and Dates) Leave blank. It excludes travel time. This is the portion of the payment designated as reimbursement for Part A services under the demonstration. The total number of pints of whole blood or units of packed red cells furnished, whether or not they were replaced. When the hospital gives a discount for un-replaced deductible blood, it shows charges after the discount is applied. The amount the provider assumes will be applied to the patient’s deductible amount involving the indicated payer. 39 - 41 Value Codes and Amounts Conditional These fields contain the codes and related dollar amounts to identify the monetary data for processing ... indicated in Field 50 lines a, b, c. 55a, b, c Estimated Amount Due Not required Enter the estimated amount due from the payer indicated in Field 50 0000005716 00000 n (For third party payer internal use only.) $2,412.50 $51.90. If all deductible pints furnished have been replaced, no entry is made. 110 0 obj <>stream two digits) are to be right justified to the left of the dollar/cents delimiter. (See note following code 59 for an example.) It enters six zeros (0000.00) in the amount field if it is claiming a conditional payment because the other insurer has denied coverage or there has been a substantial delay in its payment. Where it received no payment or a reduced payment because of failure to file a proper claim, it enters the amount that would have been payable had it filed a proper claim. All codes are guaranteed to work. x�b```�w�\� c�rL`��� Effective Oct. 1, 2010, providers billing for therapy services are no longer required to report the total number of therapy visits using the following value codes: 50 Physical therapy; 51 Occupational therapy; 52 Speech therapy; 53 Cardiac rehab Regulatory Surcharges, Assessments, Allowances or HealthCare Related Taxes Payer C, Other Assessments or Allowances (e.g., Medical Education) Payer C, The amount estimated by the provider to be paid by the indicated patient. This list is not exhaustive, but it will give you an idea of some common core … The amount included in covered charges for self-administrable drugs administered to the patient because the drug was necessary for diagnostic study or other reasons (e.g., the drug is specifically covered by the payer). <]>> Color code converter. Under Medicare, each beneficiary has a lifetime reserve of 60 additional days of inpatient hospital services after using 90 days of inpatient hospital services during a spell of illness. GD�X��? 0000002424 00000 n Indicates the number of units of EPO administered and/or supplied relating to the billing period. Whole numbers (i.e. 0000009763 00000 n Value code 49 must be reported with the hematocrit value for the hospital outpatient visits prior to January 1, 2006, and for all claims with dates of service on or after January 1, 2008. 0000001918 00000 n Pasture rental rates fell the most in the Lake States (down 13.4 percent to $27.5 per acre) and the Northeast (down 7.1 percent to $29.50 per acre. Value City Furniture coupons and coupon codes for February 2021 from CouponCabin. The MSA in which HHA branch is located. Operating Indirect Medical Education Amount. The number of physical therapy visits from onset (at the billing provider) through this billing period. So for a pixel, if red is 27, set green and blue to also be 27. (Rounded to the nearest whole hour. ), Home Health Aide – Home Visit Hours (HHA only), The number of hours of home health aide services provided during the billing period. 0000006573 00000 n �8�����\6粤g����&` ����Z ��i�bE�� For patients just starting, use the most recent value prior to the onset of treatment. That portion of a higher priority PHS or other Federal agency’s payment, made on behalf of a Medicare beneficiary that the provider is applying to covered Medicare charges. It uses the amount provided by the indirect medical education field in PRICER. Medicare Coinsurance Amount in the Second Calendar Year in Billing Period. The amount the provider assumes will be applied toward the patient’s co-payment amount involving the indicated payer. The product of the number of coinsurance days used in the first calendar year of the billing period multiplied by the applicable coinsurance rate. Amount the provider estimates will be paid by the indicated payer. PAYER NAME. endstream endobj 109 0 obj <>/Size 85/Type/XRef>>stream Required on all claims with type f admission of 4 and on other claims as required by State law. Value Code 44 . This is the portion of the payment designated as reimbursement for Part B services under the demonstration. The provider reports right justified in the cents area. Prescription drugs paid for out of a long-term care facility resident/patient’s funds in the billing period submitted (Statement Covers Period). The coin value for Seated Liberty dollars, half dollars and quarters are based on a number of well-known minor details that can be found on the otherwise identical artwork used. They represent arterial blood gas or oxygen saturation levels. Since 2019, pastureland rental rates increased the most in the Mountain States (up 6.7 percent to $5.70 per acre) and the Appalachian States (up 6 percent to $23.50 per acre). Value codes and amounts: UB-04 fields 39–41 A few common value codes used on Part A SNF claims are: 80—Covered days. (Not reported by providers.) Offset to the Patient-Payment Amount – Prescription Drugs. Medicare Coinsurance Amount in the First Calendar Year in Billing Period. Offset to the Patient-Payment Amount – Other Medical Services. The standard charge for outpatient surgery where the provider has such a charging structure. Code identifies the corresponding value amount at which a health care facility determines the eligibility threshold for charity care. View Charts. The amount the provider assumes is applied to the patient’s co-payment amount involving the indicated payer. For Medicare, use this code only for reporting Part B coinsurance amounts. Dental services paid for out of a long-term care facility resident/patient’s funds in the billing period submitted (Statement Covers Period). Where it received no payment or a reduced payment because of failure to file a proper claim, it enters the amount that would have been payable had it filed a proper claim. Indicates that the charges shown are included in billed charges FL 47, but a separate billing for them will also be made to the carrier. Enter the appropriate Value Code (listed below). The provider counts only hours spent in the home. If it received no payment or a reduced no-fault payment because of failure to file a proper claim, it enters the amount that would have been payable had it filed a proper claim. Covered Self-Administrable Drugs – Diagnostic Study and Other. This is the amount Medicare would have reimbursed the provider for Part A services if there had been no demonstration. The amount included in covered charges for self-administrable drugs administered to the patient in an emergency situation. Find the best Match.com Coupon Code available online to get the best savings. (The hospital uses this code when the bill includes inpatient charges for newly covered services that are not paid by the Managed Care Plan. It reports in whole hours, right justified to the left of the dollars/cents delimiter. For episodes in which the beneficiary’s site of service changes from one MSA to another within the episode period, HHAs should submit the MSA code corresponding to the site of service at the end of the episode on the claim. 50%. Covered Self-Administrable Drugs – Not Self-Administrable in Form and Situation Furnished to Patient. 0000007816 00000 n Inpatient charges covered by the Managed Care Plan. Using the correct combination of codes is the key to minimizing delays in claims processing. Other medical services paid for out of a long-term care facility resident/patient’s funds in the billing period submitted (Statement Covers Period). Offset to the Patient-Payment Amount – Dental Services. The number of speech therapy visits from onset (at the billing provider) through this billing period. It does not include any PPS capital DSH adjustment in this entry. These are days used in the year of admission. The number of days covered by the primary payer as qualified by the payer. It uses the amount provided by the disproportionate share field in PRICER. Sale. This value or value 59 is required on the initial bill for oxygen therapy and on the fourth month’s bill. Chiropractic Services paid for out of a long term care facility resident/patient’s funds in the billing period submitted (Statement Covers Period). For example, 31,060 units are administered for the billing period. two digits) are to be right justified to the left of the dollar/cents delimiter. 3 uses today. PDF download: MSP Billing & Adjustments – CGS. (NOTE: Medicare blood deductibles should be reported under Value Code 6.). The list gets updated daily, and almost all of them are verified and free to use. 38 Responsible Party Name and Address Optional. IMPLEMENTATION DATE: October 4, 2010 . Read this complete Texas Tax Code § 33.50. For Part A coinsurance amounts use Value Codes 8-11. 85 26 startxref Oxygen Saturation (02 Sat/ Oximetry) It enters six zeros (0000.00) in the amount field if it is claiming a conditional payment because there has been a substantial delay in its payment. Looking for 50% Off Match Subscription for February 2021? The hospital uses this code also when outpatient treatment is for mental illness, and professional component charges are included in FL 47. Podiatric services paid for out of a long-term care facility resident/patient’s funds in the billing period submitted (Statement Covers Period). This applies to all outpatient hospital and skilled nursing facility (SNF) claims and home health agency (HHA) claims to which an interim rate is applicable. Medicare Lifetime Reserve Amount in the First Calendar Year in Billing Period. Offset to the Patient-Payment Amount – Podiatric Services. The product of the number of lifetime reserve days used in the second calendar year of the billing period multiplied by the applicable lifetime reserve rate. Whole numbers (i.e. 39-41 Value Codes and Amounts Required. Five digit ZIP Code of the location from which the beneficiary is initially placed on board the ambulance. Regulatory Surcharges, Assessments, Allowances or HealthCare Related Taxes Payer B, The amount of regulatory surcharges, assessments, allowances or health care related taxes pertaining to the indicated payer. The provider may not use this code on Part B bills. Please ensure that revenue codes and procedure codes reflect the diagnoses and services rendered. If the charge per pint varies, the amount shown is the sum of the charges for each un-replaced pint furnished. Categories Log in Join for free. Where it received no payment or a reduced payment because of failure to file a proper claim, it enters the amount that would have been payable had it filed a proper claim. Core Values List. It may not use this code on Part B bills. 0000009193 00000 n If a code “C3” or “C4” is in FL 24-30, indicating that the QIO has denied all or a portion of this billing period, the provider shows the number of days determined by the QIO to be covered while arrangements are made for the patient’s post discharge. Vision and eye services paid for out of a long-term care facility resident/patient’s funds in the billing period submitted (Statement Covers Period). Value Codes 50-53 . (Not reported by providers.) 100% working Value World Promo Code, updated and verified this February 2021. 0000005951 00000 n The contractor reports to the left of the dollar/cents delimiter. %PDF-1.4 %���� Inpatient Professional Component Charges Which Are Combined Billed, The sum of the inpatient professional component charges that are combined billed. The provider uses this code only on bills spanning 2 calendar years when coinsurance days were used in the year of discharge. 59. The amount assumed by the provider to be applied toward the patient’s co-payment amount involving the indicated payer. RGB values are in range of 0..255. It does not include any PPS capital IME adjustment in this entry. Offset to the Patient-Payment Amount – Health Insurance Premiums. (See note following this code for an example.). A. 0000000016 00000 n It does not include any pass through amounts such as that for direct medical education nor interim payments for operating IME and DSH. 0000000816 00000 n $27.66 $0.11. Blood is reported only in terms of complete pints rounded upwards, e.g., 1 1/4 pints is shown as 2 pints. Third-digit subcategories for the revenue code are included in the National Uniform Billing Committee (NUBC) Official UB-04 Data Specifications Manual. Enter the appropriate code indicated below, right justified to the left of the dollar/cents delimiter. 0000001555 00000 n Welcome to the American Hospital Association’s eBooks homepage. Discounts average $11 off with a True Value promo code or coupon. See Details. When the primary payer pays less than the actual charges (e.g., under the terms of a preferred provider agreement) and is less than the amount the provider is obligated to accept as payment in full (e.g., because of imposition of a primary payer’s deductible and/or co-payment, but not because of failure to file a proper claim), 0000005163 00000 n For Part A coinsurance amounts use Value Codes 8-11. This Part A payment reflects the shift of payments from the Part A to the Part B Trust Fund as mandated by §1812(a)(3) of the Social Security Act. The HHA reports the number in dollar portion of the form locator right justified to the left of the dollar/cents delimiter. Sale. The amount the provider assumes will be applied toward the patient’s coinsurance amount involving the indicated payer. Background: This instruction removes the requirement for providers to report the total number of therapy visits using value code 50 – physical therapy, 51 – occupational therapy, 52 – speech therapy, and 53 – cardiac rehab. To provide for the recording of hospital’s most common semi-private rate. The dollar amount that was used to meet the recipient’s spend-down liability for this claim. The provider counts only the hours spent in the home, excluding travel time. The product of the number of un-replaced deductible pints of blood supplied times the charge per pint. 0 This value or value 59 is required on the initial bill for oxygen therapy and on the fourth month’s bill. Save with Value City Furniture coupon codes and 50% Off promo code discounts for February 2021. Check out our exclusive offers and cash back bonuses. (The only covered Medicare charges for an ordinarily non-covered, self-administered drug are for insulin administered to a patient in a diabetic coma. These are days used in the year of admission. Best Value Copy Offer - 50% Off On Shipping Sitewide Purchase a wide range of products at Best Value Copy, just receive Best Value Copy Offer - 50% off on Shipping Sitewide. NOTE: A six zero value entry for Value Codes 12-16 indicates conditional Medicare payment requested (000000). Where the hospital charges only for the blood processing and administration, (i.e., it does not charge a “replacement deposit fee” for un-replaced pints), the blood is considered replaced for purposes of this item. • Value code 80 -- Covered days The number of days covered by the primary payer as qualified by the payer Note: Value code 80 is used to report a combined total of the beneficiary’s full days and coinsurance and lifetime reserve days, as applicable. Color conversions. Decimals (i.e. That portion that the provider was obligated or required to accept from a primary payer as payment in full when that amount is less than charges but higher than the amount actually received. For use with Revenue Code 0637. Codes/Dates Leave blank. Submit a Coupon. (Not reported by providers.) 50 True Value coupons now on RetailMeNot. OFF. The product of the number of coinsurance days used in the second calendar year of the billing period times the applicable coinsurance rate. Up to 50% Off February Sale. The provider counts only hours spent in the home. ��e�o0�`O�; �`�P�� Days of care not covered by the primary payer. Report the number of days covered by Medicare Part A. appropriateness, with a particular bill. Code indicates the amount of Medicare additional payment for new technology. 0000003109 00000 n 42 -48 At least 1 charge line is required The most recent hemoglobin reading taken before the start of this billing period. The FI reports the operating disproportionate share amount applicable. Welcome. This article is based on CR 6899, which advises you that the requirement for providers to report the total number of therapy visits using value codes 50 – physical therapy, 51 – occupational therapy, 52 – speech therapy, and 53 –. It excludes travel time. Some commonly used condition codes and the conditions they indicate are: 20—Beneficiary requested billing. (Effective 1/01/05), Height of patient in centimeters. That portion of a higher priority VA payment made on behalf of a Medicare beneficiary that the provider is applying to Medicare charges on this bill. The inpatient Medicare days occurring after the 60th day and before the 91st day or inpatient SNF/Swing Bed days occurring after the 20th and before the 101st day in a single spell of illness. Provider’s percentage of billed charges interim rate during this billing period. 0000002844 00000 n Palladium. Color codes chart. ), Location Where Service is Furnished (HHA and Hospice). Below is a list of core values commonly used by leadership institutes and programs. Effective 10/16/2003. That portion of a higher priority BL payment made on behalf of a Medicare beneficiary that the provider is applying to covered Medicare charges on this bill. The provider uses this code only on bills spanning 2 calendar years when lifetime reserve days were used in the year of discharge. %%EOF 0000003874 00000 n 50% OFF. For more detailed codes research information, including annotations and citations, please visit Westlaw. The number of cardiac rehabilitation visits from onset (at the billing provider) through this billing period. Code indicates the percentage of charity care eligibility for the patient. It reports in whole hours, right justified to the left of the dollars/cents delimiter. FL 50. It reports in whole hours, right justifying to the left of the dollar/cent delimiter. Round to two decimals or to the nearest whole percent. Using the latest Value Village Promo Codes or Coupon Codes, you can enjoy flat 50% OFF discount on all orders for a limited period. ), Number of Units of EPO Provided During the Billing Period. The amount included in covered charges for self-administrable drugs administered to the patient because the drug was not self-administrable in the form and situation in which it was furnished to the patient. See The Medicare Benefit Policy Manual). 0000008499 00000 n 0000004500 00000 n (Rounded to the nearest whole hour. |%�)َm����3�y����t{���o�����}gh�����.LE� _ۼ/=ʛڕSZH���P���)��[H=?�=͇*[��,m�����kRe��-�EѴ;Z�'��.LKP�R��. (For use by third party payers only.) ?S{�)��������C��Be�n�A�"S;� Code. Hearing and ear services paid for out of a long-term care facility resident/patient’s funds in the billing period submitted (Statement Covers Period). one digit) are to be reported to the right. If payment denied or applied to deductible, bill Medicare … Revised February 13, 2015 • H-017-10 … value code as usual. 0000003186 00000 n If more than one patient is transported in a single ambulance trip, report the total number of patients transported. The FI reports operating indirect medical education amount applicable. Silver. To get your coin worth, have it appraised by a Numismatist or professional coin grading service such as NGC or PCGS. For use with Revenue Code 0637. Medicaid-eligibility requirements to be determined at State level. The number of un-replaced deductible pints of blood supplied. Save 50% w/ Value World Discount Code & Promotion Code at valuecom.com. HEX value is 6 digits (rrggbb). Where the provider received no payment or a reduced payment because of failure to file a proper claim, it enters the amount that would have been payable had it filed a proper claim.
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