
FAA Form 5010-5 1996-2025 free printable template
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So the first thing you notice is that the overall look and feel of the form is exactly the same as it used to be the main difference between 50 10 and 40 10 is just an expansion of the specifications so right away you see there's a lot more patient relationships to insured other additional options that are available as you scroll down you'll see in the box 14 of the Hickman form you'll notice that it's not just a date of current there are several other dates that we've provided you the option of populating but overall the look and feel is very much the same as it always has been the line items with just the same diagnosis codes there's no huge differences here the data will populate itself just as it has all along one thing you'll notice is that you have a lot of these more sections we've provided the option to add data in as the practice may need specific to its claims so unpopular one I've just clicked on the more button for the rendering provider, so you can add in here the rendering provider information just as an example you can see who the provider was actually and perform the services of the claim we can expose that up just by clicking on the close button in each field will have these additional more options where you can add additional information specific to the line-item are specific to a date or specific to whatever piece of information you're talking about and that's really it on the form very simple and straightforward Save Changes will all work exactly the same
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