Statutes, codes, and regulations
Virginia Administrative Code
Title 12 - HEALTHAgency 5 - DEPARTMENT OF HEALTH
Chapter 218 - RULES AND REGULATIONS GOVERNING OUTPATIENT HEALTH DATA REPORTING
Form - FORMS (12VAC5-218)

Va. Admin. Code tit. 12, agency 5, ch. 218, form FORMS (12VAC5-218)

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Current through Register Vol. 41, No. 6, November 4, 2024
Form - FORMS (12VAC5-218)

National Uniform Billing Committee Uniform Billing Form UB-04 (undated)

Centers for Medicare and Medicaid Health Insurance Claim Form, Sample Form, CMS 1500 (approved 2/12)

Va. Admin. Code tit. 12, agency 5, ch. 218, form FORMS (12VAC5-218)

Amended, Virginia Register Volume 31, Issue 22, eff. 8/29/2015.

Statutory Authority: §§ 32.1-12 and 32.1-276.6 of the Code of Virginia.