Reference: Ref-06197
| Reference Name: | DFS-F5-DWC-90-D (UB-04) |
| Agency: | 69 Department of Financial Services 69L Division of Workers' Compensation |
| Original Document(s): |
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| Modified Document(s): | No Modified document(s). | |||||
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Disclaimer: External links within the reference material are subject to change outside of the rulemaking process.
Rules/Notices using this Reference Material| Notice / Adopted |
Description | ID | Publish Date |
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|---|---|---|---|---|
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Forms Incorporated by Reference for Medical Billing, Filing and Reporting | 17114600 |
Effective: 02/18/2016 |
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