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MAP1460
(Fl. Pink –
11/2” w x 7/8” h)
Corrective Claim
250 labels per roll
$6.50
per roll
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MAP1480
(Fl. Green –
11/2” w x 7/8” h)
Primary EOB Attached
250 labels per roll
$6.50
per roll
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MAP6200
(Teal/Black –
11/2” w x 11/2” h)
INSURANCE This office has not
received an explanation
250 labels per roll
$12.00
per roll
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MAP2610
(Fl. Chartreuse –
31/4” w x 13/4” h)
RESUBMISSION
250 labels per roll
$8.50
per roll
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MAP2650
(Fl. Green –
11/2” w x 7/8” h)
Documentation Attached DO NOT
SEPARATE FROM CLAIM
250 labels per roll
$6.50
per roll
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MAP2670
(Fl. Pink –
11/2” w x 7/8” h)
RESUBMISSION: This is not a
duplicate billing.
250 labels per roll
$6.50
per roll
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MAP6220
(Orange/Black –
11/2” w x 11/2” h)
Second Submission Original Claim
was sent on:
250 labels per roll
$12.00
per roll
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MAP2800
(Fluorescent Red –
31/4” w x 13/4” h)
PLEASE PROCESS THIS CLAIM
AS:Rebill
250 labels per roll
$8.50
per roll
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MAP2690
(Fl. Orange –
11/2” w x 7/8” h)
Medicare EOB Attached
250 labels per roll
$6.50
per roll
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MAP7050
(Fl. Orange –
11/2” w x 7/8” h)
Primary EOB Attached
-Medicare EOB Attached
250 labels per roll
$6.50
per roll
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