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Across
  1. 1. SUBMITTED BY A PROVIDER FOR PAYMENT
  2. 3. THE EMPLOYER
  3. 5. PREFERRED MEDICAL DOCTOR
  4. 6. THE CONTRACT HOLDER
  5. 7. AN INJURY CAUSED BY A FORCE OUTSIDE OF THE BODY
  6. 10. CLAIMS PROCESSED REPORT
Down
  1. 2. MEDICAL SERVICES RECEIVED WHILE A RESIDENT IN THE HOSPITAL
  2. 4. A PARAGRAPH THAT ADDS AND REMOVES BENEFITS
  3. 8. SET DOLLAR AMOUNT DUE AT TIME OF SERVICE
  4. 9. DURABLE MEDICAL EQUIPMENT