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The Providers with Provider Numbers report includes information from the Providers master file in File Maintenance. Information on the report pulls from the Modify Provider Information window for providers with provider numbers defined on the Practice tab. The report includes the following information:
| Column | Description | Data Populates From |
|---|---|---|
| Prac Name | Practice Name | Practice associated with the provider |
| Loc Name | Location Name | Service Location field of the Practice tab.
|
| Location Subgrouping 1 | Location Subgroup 1 | SubGrouping One field of the Locations master file
|
| Location Subgrouping 2 | Location Subgroup 2 | SubGrouping Two field of the Locations master file
|
| Name | Provider Name | Last Name, First Name and Middle Name fields of the Demographics tab |
| Display As | Display As Name | Display As field of the Demographics tab |
| Rend | Rendering Provider Indicator | Rendering provider at this practice check box of the Practice tab Displays Y or blank |
| Hid | Delete Indicator | Hide check box Displays Y or blank |
| DEA # | DEA Number | DEA Number field of the Practice tab |
| State Lic # | State License Number | State License Number field of the Practice tab |
| Tax ID # / SSN | Tax ID Number / Social Security Number | Tax ID Number/SSN field of the Practice tab |
| Prov Type | Provider Type | Prov Type field of the Practice tab |
| Specialty | Specialty | Specialty field of the Practice tab |
| Grp Payer Name | Group Payer Name | Practice tab > Group Information section > Modify Provider Practice Payer window > Payer Name field |
| Provider # | Provider Number | Practice tab > Group Information section > Modify Provider Practice Payer window > Provider Number field |
| From CPT4 ID | From CPT4 Code | Practice tab > Group Information section > Modify Provider Practice Payer window > CPT4 Provider Nbrs section > CPT4 field |
| To CPT4 ID | To CPT4 Code | Practice tab > Group Information section > Modify Provider Practice Payer window > CPT4 Provider Nbrs section > Thru CPT4 field |
| Ovr Provider # | Override Provider Number | Practice tab > Group Information section > Modify Provider Practice Payer window > CPT4 Provider Nbrs section > Provider Number field |
| Group Name | Group Name | Practice tab > Group Information section > Modify Provider Practice Payer window > Group Name field |
| SIM Exc | SIM Exception | Practice tab > Group Information section > Modify Provider Practice Payer window > SIM Exception field |
| Contract Exc | Contract Exception | Practice tab > Group Information section > Modify Provider Practice Payer window > Contract Exception field |
| Name/Org | Name/Organization | Practice tab > Group Information section > Modify Provider Practice Payer window > Name/Organization field |
| Addr 1 | Address 1 | Practice tab > Group Information section > Modify Provider Practice Payer window > Street 1 field |
| Addr 2 | Address 2 | Practice tab > Group Information section > Modify Provider Practice Payer window > Street 2 field |
| City | City | Practice tab > Group Information section > Modify Provider Practice Payer window > City field |
| State | State | Practice tab > Group Information section > Modify Provider Practice Payer window > State field |
| Zip | Zip Code | Practice tab > Group Information section > Modify Provider Practice Payer window > Zip field |
| County | County | Practice tab > Group Information section > Modify Provider Practice Payer window > Country field |
| Country | Country | Practice tab > Group Information section > Modify Provider Practice Payer window > County field |
| Email Addr | Email Address | E-mail Address field of the Demographics tab |
| Referring | Referring Indicator | Referring check box of the Provider Types tab Displays Y or blank |
| Prim Care Phys | Primary Care Physician Indicator | Provider Types tab > Primary Care Phys check box Displays Y or blank |
| Admitting | Admitting Indicator | Admitting check box of the Provider Types tab Displays Y or blank |
| Fst Consult | First Consulting Indicator | First Consulting check box of the Provider Types tab Displays Y or blank |
| Sec Consult | Second Consulting Indicator | Second Consulting check box of the Provider Types tab Displays Y or blank |
| Supervisor | Supervising Provider | Supervising provider at this practice check box of the Practice tab Displays Y or blank |
| Pat Prov UD1 - 12 | Patient Provider 1 - 12
| Practice Level Provider Types 1-12 check boxes of the Provider Types tab Displays Y or blank |
| Submitter Group | Submitter Group | |
| Supervisor Req'd | Supervisor Required Indicator | Supervisor required check box of the Practice tab Displays Y or blank |
| NPI | NPI | National Provider ID field of the System tab |
| Eff Dt | Effective Date | Practice tab > Group Information section > Modify Provider Practice Payer window > Effective Date field |
| Exp Dt | Expiration Date | Practice tab > Group Information section > Modify Provider Practice Payer window > Expiration Date field |
| Supv Ind | Enable Supervisor Billing Indicator | Enable Supervisor Billing check box of the Practice tab Displays Y or blank |
| Supv Exc Ind | Supervisor Billing Exception Indicator | Practice tab > Group Information section > Modify Provider Practice Payer window > Disable Supervisor Billing check box Displays Y or blank |
| NonPerson Ind | Bill as Non-Person Indicator | Bill as Non-Person check box of the Practice tab Displays Y or blank |
| Bill SSN Ind | Bill SSN with SY Sec Ref Indicator | Practice tab > Group Information section > Modify Provider Practice Payer window > Bill SSN with SY secondary reference check box Displays Y or blank |
| Suspend Eff Dt | Suspend Effective Date | Practice tab > Group Information section > Modify Provider Practice Payer window > Suspended Eff Dt field |
| Ordering | Ordering Provider | Ordering check box of the Provider Types tab Displays Y or blank |
| Locum Tenens Ind | Locum tenens indicator | Locum Tenens check box of the Provider Types tab Displays Y or blank |
Use columns to filter data on the report. Column filter options include the following:
Use additional filters to filter data on the report. Additional filters include the following:
Use columns to sort and group data on the report. Column sorting options include the following:
Use columns to sub-total and total data on the report. Column total options include the following: