Efficiency App | Adm.

Patient Book

Rendering Provider

Patient

Facility

Carrier

Admission Date

Start Date of Service

Final Date of Service

Discharge Date

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id	Status	AdmissionDate	Patient_Name	Facility	RenderingProvider	Carrier	room_bednumber	insurance_verification	Copay	Deductable	insurance_notes	Anticipated_Discharge_Date	Discharge_Date	Claim_Notes

Payer Name	Payer ID	Payer Claims Address Line 1	Payer Claims Address Line 2	Payer Claims City	Payer Claims State	Payer Claims Zip Code

	Procedure Code	Date Of Service	Modifier	POS Code	Value

Name	DateOfBirth	TaxIDNumber	IndividualNPI	GroupNPI	IndividualPTAN	GroupPTAN	TaxonomyCode	DEANumber	CAQHID	MedicaidID	MedicareID	MalpracticeInsuranceCarrier

Facility	NPI	TIN	Fax	Phone	Address	City	State	Zip Code

Patient ID	Patient Name	Date of Birth	Primary Insurance ID	Relationship To Insured	Gender	Address Line 1	Address Line 2	City	State	Zip Code	Primary Diagnosis	ICD 10	Secondary Diagnosis	ICD 10