Box 76 - Attending Provider Name and Identifiers

Updated May 06, 2025 19:13

Box Definition

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

In Kipu RCM

The rendering provider information is managed within the Rendering Providers section of the Practice Admin. To update the rendering provider on claims with UR-required services, click here.

EDI Loop and Segment

Loop 2310A, Segment NM1/71/09. For additional information on loops and segments, click here.

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Box 76 - Attending Provider Name and Identifiers

Box Definition

In Kipu RCM

EDI Loop and Segment

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