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Get IL HFS 1409 2009-2022

/NPI # 5. Provider Telephone # 6. Provider Name 7. Physician Name 9. Physician Street Address 8. Provider Street Address 10. Provider City 3. Birthdate Zip Code State State 11. Physician City 12. Diagnosis Code 13. Additional Diagnosis 14. Diagnosis Description Zip Code 15. Patient Height / Weight Description 16. Procedure Code Prov Charge Approved HFS Amt 18. Procedure Code Prov Charge Approved HFS Amt Approved HFS Amt Approved HFS Amt Description 20. Procedure Code Prov Ch.

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