Please review the lecture on how to complete CMS-1500 Claim Forms through the link below:
https://cccconfer.zoom.us/rec/play/vJUvfrip_DM3Tt3G4wSDUPVwW9W_fays0yRLrPANxRm1VCVWMFHzYLAV-geWwMPLha_aPXIZDzYRnA?continueMode=true&_x_zm_rtaid=ls3Avd1CQ1qc-bGbltJuow.1596418773153.e03dca8b59cdfb0541278939073241c5&_x_zm_rhtaid=162
Afterwards, use the Henry Jackson attachment to create a CMS-1500 Claim Form for his encounter.
