ࡱ> ED  `\pRaj Ba==- N.8X@"1Verdana1Verdana1Verdana1Verdana1Verdana1QTahoma1QTahoma1Verdana1Verdana1 Verdana1 Verdana"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)$[$-409]dddd\,\ mmmm\ dd\,\ yyyy dd/mm/yyyy;@                + ) , *    !<"@ !<"@  H+    !<"@      h )  l )  "x"a@ @ *   H+ `A Sheet1dSheet2 eSheet3"ZR 3 A@@  Svc CodeProvModifier Diag CodeSvc DatePatient Name, Init.Add. Information Facilty Nbr:Calls Patient PHNInfo Func. Cntr: DR.$ Please turn your caps lock onE xcc   <^'Y,a0i4q8y<@DHLPmT  dMbP?_*+%&?'?(?)?M\\LOGICSERVER\hp LaserJet 1320C odXXLetterDINU"p$]'pSMTJ`hp LaserJet 1320 PCL 6InputBinFORMSOURCERESDLLUniresDLLResolution600dpiFastResFalseOrientationPORTRAITHPOrientRotate180FalseDuplexNONEPaperSizeLETTERMediaTypeAUTOOutputBinMainBinFaceDownEconomodeFalseTextAsBlackFalseTTAsBitmapsSettingTTModeOutlineRETChoiceTruePSAlignmentFileHPZ3A041PSServicesOptionHLPWithLightsHPPosterPrintingFalseHPPosterPrintingOptionPOSTER_2PrintQualityGroupPQGroup_4HPColorModeMONOCHROME_MODEHPPDLTypePDL_PCL6HPPJLEncodingUTF8HPJobAccountingHPJOBACCT_JOBACNTHPBornOnDateHPBODHPJobByJobOverrideJBJOHPXMLFileUsedhpc13206.xmlHPSmartDuplexSinglePageJobTrueHPSmartDuplexOddPageJobTrueHPManualDuplexDialogItemsInstructionID_01_FACEDOWN-NOROTATEHPManualFeedOrientationFACEUPHPOutputBinOrientationFACEDOWNHPManualDuplexPageOrderEvenPagesFirstHPMapManualFeedToTray1FalseHPPrintOnBothSidesManuallyFalseHPStraightPaperPathFalseHPCoversFirst_PageAlternateLetterHeadFalseHPManualDuplexDialogModelModelessHPLpiSelectionNone$IUPH dLetter [none] [none]Arial4Pd?RAJ<Automatic>600dpi  d Default Print Settingsi j. m @EXCEL.EXE"dXX??U} @} }  }  } `} } @ } } `"^    0                                     Dln~  !"#$%&'()*+,-./0123456789:;<=>? !"#$%&'()*+,-./0123456789:;<=>?Dl @ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_Dl `abcdefghijklmnopqrstuvwxyz{|}~`abcdefghijklmnopqrstuvwxyz{|}~Dl Dl Dl Dl Dl           Dl  !"#$%&'()*+,-./0123456789:;<=>? !"#$%&'()*+,-./0123456789:;<=>?Dl @ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]@D  (  ~  <P\XPP?]4@P\, ^1NNflCF @<APatient's province of health plan. Leave Blank for AB patients. <Z? @@   BhQ\ XPP?_s]4@hQ\, (OLCvX q<rPatient's health care number, PHN or ULI. For AB patients numbers are 9 digits long and end in either a 0 or a 1 <lp q~~  <Q\XPP?s]4@Q\, }"-0J۽! <Number of calls or units < ~~  <0R\XPP?Js]4@0R\,  P DsZ 5<6Fee modifiers. If more than one, separate with commas<85~~  <R\XPP?)s]4@R\,  O<؊@& SQ| 1<2Diag Code. If more than one separate with commas <!0 1~~  <R\XPP?s]4@R\,  zdcBE *vFM '<(Date of service in the format DD-MM-YYY<'~~  <\S\XPP? &s]4@\S\,  25O4R ,<-Patient's surname and initial or first name.<,xf+~~  <S\XPP? s]4@S\,  80띻_@Kz6E '<(Referring practitioner name and Prac ID<'   B$T\ XPP?U9]4 @$T\, TO(OpM  J<KData on this sheet must be entered in upper case or you will get an error.<J%~~   <T\XPP?k/s]4 @T\ ~8dcHBeK  < Service code<H R  BT\ XPP?]4@T\p IKGu# <After entering your claim data save this sheet with the name something like your name and the date. E.g. SMITH_2011_02_05.xls Email this sheet to medclaims@logicresources.com You can also print this sheet and fax it to (403) 275-7908<FRaj RajRajRaj RajRajRajRajRajRajRaj>@7> laLLAqAush]]   d  dMbP?_*+%"??U>@7   e  dMbP?_*+%"??U>@7 Oh+'0HP\h RajRajMicrosoft Excel@}:@*qў:@Pm3A՜.+,0 PXt |  Logic Resources' Sheet1Sheet2Sheet3  Worksheets  !"#$%&'()*+,-./012356789:;=>?@ABCRoot Entry FWorkbookfSummaryInformation(4DocumentSummaryInformation8<