The Purchased Services Attachment is used to capture purchased service information that may be required on the claim. When a provider contracts with another provider or vendor to perform the technical component of a diagnostic test. For example, laboratory tests.

Data Field Information
| Prompt | Response | Req | Len |
|---|---|---|---|
| Referral Source | Enter the code you want or click the magnifying glass to search the table. | 1 | |
| Purchased From (NPI) | Informational Only - Displays the NPI number for the referral source selected. | 1 | |
| Price | Enter the price. | 18 |