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PAYER ID: 12B74 / 12B75 SUBMITTER ID: P0084393 Eden ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account 1 Provider Organization Practice/ Facility Name
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Submitter id p0084393 is a unique identification number assigned to a submitter in a particular system or process.
The individual or entity who has been assigned submitter id p0084393 is required to file it.
To fill out submitter id p0084393, you need to provide the required information as specified by the system or process that uses the submitter id.
The purpose of submitter id p0084393 is to uniquely identify a submitter in a particular system or process, allowing for easy tracking and recognition.
The specific information that must be reported on submitter id p0084393 depends on the system or process that uses it. It could include personal or business details, transaction data, or other relevant information.
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