Utilities

Patient

Prescriber

Drug

info

Created By/On: Devel# 11/26/2015 | 5:23:47 AM

Maintained By/On: Jayden Smith 02/12/2018 | 5:06:479 AM

Hospice Exports

Export

Path / File

File Format

Begin Fill Date

End Fill Date

Include

Hospice Patients Only

Plans

Selected Plans
[ALL]

Patients

Selected Patients
[ALL]

Care Facility

Selected Care Facility
[ALL]

Search Criteria

Third Party

BIN

Plan Name	BIN	Payer	Group	PCN
CA CMC	610144	CA CMC		DOCER
CMS 1500 Claim Form	610785	CCMS 1500 Claim Form(2012)		ERCLCERT
Eligibility Commercial Plan	610785	Commercial Plan		COMMCF
Eligibility Medicare Plan	610785	Medicare Plan		COMMCF

Search Criteria

Date of Birth

Enter last name, first name

MRN

Phone

Address

City

State

ZIP

Name	Date of Birth	Address	City	State	ZIP	Phone	CF	Status
Smith James	10/07/1978	88 Center Rd	Bedford	OH	44146	715-361-4850		Active
Maria Rodriguez	10/07/1976	2349 Spinnaker Lane	Joliet	LA	60432	724-376-4350		Active
Smith James	10/07/1978	1566 Elm Drive	Cambridge	NY	12816	532-247-7219		Active

Search Criteria

Name

Abbreviation

Phone

Fax

Address

City

State

ZIP

Name	Abbrev	Address	City	State	ZIP	Phone	Status
Care Facility Lite Test	CFL	88 Center Rd	Bedford	OH	44146	715-361-4850	Active
Care Facility Lite	CFL	2349 Spinnaker Lane	Joliet	LA	60432	724-376-4350	Active