Loop 2320 (Claim Level)/FL 54 A-C

| Prior Payments for Primary, Secondary, and Tertiary | Source |
|---|---|
| Required when the payer listed has paid an amount to the provider toward this bill. | Provider or Medicare records |
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| Prior Payments for Primary, Secondary, and Tertiary | Source |
|---|---|
| Required when the payer listed has paid an amount to the provider toward this bill. | Provider or Medicare records |