Confidential Screening/Billing Report (PM 160) Claim Form ...
Periodic: Enter a check mark (() if the patient has previously received a CHDP health assessment and tests by any provider. Fees: FEES. These instructions apply to the standard PM 160 (not to the. Standard PM 160 PM 160 Information Only) claim form. Providers are encouraged to bill at their usual and customary charges. ................
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