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