Required Invalid date
Required Invalid date
Required Must be between 2 to 124 Invalid Data
,
,
,
,
Required Must be a 2-digit number. Ex: "01".
,
,
Required
,
,
Required
,
,
,
,
,

,
,
,
,
Claim Lines Diagnostic Procedure Codes Date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Procedure codes
only, no modifiers.
Required Invalid date
Please correct the errors above.
EDC Analyzer™ Results
Recommended Visit Level:

These results are for reference and illustration purposes only and may not reflect the actual payment performance in the payer’s claims management system and, therefore, cannot be used as information or evidence in an adjudication or appeal environment.