Confidential Screening/Billing Report (PM 160) Claim Form ...
Immunizations IMMUNIZATIONS. When billing for immunizations, enter the code for the immunization and the name of the vaccine on a blank line in the Immunizations area. Enter a check mark (() in either column A or B for each immunization and enter the appropriate fee. Note: Fees do not apply to the PM 160 Information Only claim form. ................
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