Box 76 - Attending Provider Name and Identifiers

Box Definition

Box 76 on the UB-04 claim form displays the Attending Provider's first and last name and identifiers (NPI and Taxonomy).

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In AveaOffice

To change the Attending Provider on the UB-04 claim form:

  1. Navigate to Attendance.
  2. Select the date range.
  3. Select the "lock" symbol on the treatment to unsubmit.
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  4. Select the "Edit" pencil symbol.
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  5. Update the Rendering Provider dropdown
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  6. Select "Save".

 

EDI Loop/Segment

Loop 2310A, Segment NM1/71/09

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