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Get Sample Superbill 2014-2024

Er's Federal Tax ID#, National Provider Identifier ("NPI"), CPT Code for each date of service, and the patient’s ICD-9 diagnosis. Only basic/commonly utilized CPT Codes are listed here. It is up to the provider to determine which CPT Code(s) to utilize. It is recommended that providers contact the client's insurance carrier regarding the use of CPT Codes. (Note: ICD-9 Codes remain in use for insurance billing purposes until approx. 10/2015) Patient name ________________________________________.

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