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):
11/18/2015
Modified Document(s): No Modified document(s).
Description:

Disclaimer: External links within the reference material are subject to change outside of the rulemaking process.

Rules/Notices using this Reference Material
Notice /
Adopted
Section Description ID Publish
Date
View Text Final
69L-7.720
Forms Incorporated by Reference for Medical Billing, Filing and Reporting 17114600 Effective:
02/18/2016