UB-04 Bingo - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.

1. HCPCS/ Rates _______
2. Statement Covers Period __________
3. Patient Control Number ________
4. Value Codes _______
5. Patient's Gender _______
6. Patient's DOB _______
7. Occurence Codes ________
8. Total Charges _______
9. Admission Type _________
10. Revenue Code ________
11. Patient Name _______
12. Units of Service _______
13. Admission Date _________
14. Patient Status _______
15. Patient's Address _______
16. Condition Codes ________
17. Medical Record Number _________
18. Type of Bill _______
19. Principal Diagnosis Code _________
20. Billing Provider Name _________
21. Attending Physician Name ________
22. Admission Source _________
23. Service Date _______
24. Patient Discharge Status ________