CLINIC DATA
It will be helpful if you transfer the practice information to index cards so that it is readily available when you are ready to complete the assigned case studies for each chapter.
CLINIC/PROVIDER INFORMATION
Clinic Data:
Goodmedicine Clinic, 1 Provider St., Anytown USA 12345
Employer Identification #: 11-123456
BC/BS Group # GC12340 PAR
Medicare Group # J1110 PAR
CHAMPUS NonPAR
Phone Number (101) 111-2222
PHYSICIAN DATA
Janet B. Surgeon, General Surgery - SSA 000 11 1111
BCBS PIN#12341
Medicare PIN# J1111
UPIN JS1111
Medicaid PIN#JBS1111
T.J. Stitcher, General Surgery – SSA 222 22 2222
BCBS PIN#12342
Medicare PIN# T2222
UPIN JS1111
Medicaid PIN#JBS1111
Nancy J. Healer, Internal Medicine – SSA 333 33 3333
BCBS PIN#12343
Medicare PIN# N3333
UPIN NH3333
Medicaid NJH3333
Henry C. Cardiac, Family Practice – SSA 444 44 4444
BCBS PIN#12344
Medicare PIN# H4444
UPIN H4444
Medicaid HCC4444
Gail R. Bones, Orthopedic Medicine – SSA 666 66 6666
BCBS PIN#12345
Medicare PIN# G5555
UPIN GB5555
Medicaid GRB5555
R. K. Painfree, Physiatric/Rehabilitation Medicine – SSA 666 66 6666
BCBS PIN#12346
Medicare PIN# R6666
UPIN RP6666
Medicaid RKP6666
REFERRING PHYSICIAN’S UPINs
I. M. Gooddoc, M.D. IG7777
Erin Helper, M.D. EH8888
Arnold Younglove, M.D. AY99999
Gooden Reflexs, M.D. GR10101
D. B. Bandaid, M.D. DB12121
X.N. Raes, M.D. XN13131