SAMPLE KNEE BRACING HCFA 1500 FORM WHOL … · Sample Unilateral Knee Bracing HCFA 1500 FORM...
2
WHOLESALE DIVISION SAMPLE KNEE BRACING HCFA 1500 FORM 18011 MITCHELL SOUTH • IRVINE, CA • 92614 | PHONE 800.652.1135 FAX 800.652.1126 | WWW.VQORTHOCARE.COM Sample Unilateral Knee Bracing HCFA 1500 FORM ***Billing information, including charges listed, are intended as a sample only and VQ OrthoCare does not guarantee reimbursement from any insurance company. All billing practices are the responsibility of each individual provider.*** SAMPLE
Transcript of SAMPLE KNEE BRACING HCFA 1500 FORM WHOL … · Sample Unilateral Knee Bracing HCFA 1500 FORM...
WHOLESALWHOLESALE DIVISION
SAMPLE KNEE BRACING HCFA 1500 FORM
18011 MITCHELL SOUTH • IRVINE, CA • 92614 | PHONE 800.652.1135 FAX 800.652.1126 | WWW.VQORTHOCARE.COM
Sample Unilateral Knee Bracing HCFA 1500 FORM
***Billing information, including charges listed, are intended as a sample only and VQ OrthoCare does not guarantee reimbursement from any insurance company. All billing practices are the responsibility of each individual provider.***
SAMPLE
WHOLESALWHOLESALE DIVISION
SAMPLE KNEE BRACING HCFA 1500 FORM
18011 MITCHELL SOUTH • IRVINE, CA • 92614 | PHONE 800.652.1135 FAX 800.652.1126 | WWW.VQORTHOCARE.COM
© 2015 VisionQuest Industries, Inc. WH151820REVB
Sample Bilateral Knee Bracing HCFA 1500 FORM
***Billing information, including charges listed, are intended as a sample only and VQ OrthoCare does not guarantee reimbursement from any insurance company. All billing practices are the responsibility of each individual provider.***
SAMPLE
