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Get MD CUT5803-1S 2014-2024

S letterhead stationary IN ORDER FOR YOUR CLAIMS TO BE PROCESSED, THE FOLLOWING INFORMATION MUST BE SUBMITTED The bill must include: Provider’s full name, degree, address, phone # and CareFirst BlueCross BlueShield provider number if available. Patient’s full name Descriptions of each service or supply Date of which each service was provided The provider’s diagnosis, or patient’s chief complaint The amount charged by the provider for each service provide.

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