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Get AAFP Family Practice Management Superbill Template 2008-2024

E: Group #: Copay: Account #: Physician name: Date of service: Patient name: Address: Phone: DOB: RANK Age:          Sex: Office visit Minimal Problem focused Expanded problem focused Detailed Comprehensive Comprehensive (new patient) Significant, separate service Well visit <1y 1-4 y 5-11 y 12-17 y 18-39 y 40-64 y 65 y + Medicare preventive services Pap Pelvic & breast Prostate/PSA Tobacco counseling/3-10 min Tobacco counseling/>10 min Welcome to Medicare exam ECG w/Welcome.

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