Statement for Home Nursing Services

Statement for Home Nursing Services - (Forms/Publications)
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Title Statement for Home Nursing Services (A fillable form - 151 KB PDF)

Used to bill L&I for reimbursement of home nursing services.

Form number F248-160-000
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Keywords home care, home nursing, home services
Languages English
Valid dates 11-2013
Contact information Managing Injured Workers' Claims
Claims for Job Injuries
Treating Injured Workers
Fee Schedules
Web pages For Medical Provider

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