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DIAGNOSTIC ASSESSMENT PROGRAM PROSTATE REFERRAL FORM Telephone: 18665304464 Fax: 1877530 4425 Date: Referring Physician: Physician Billing No.: Signature of Referring Physician (Mandatory): Urologist
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8272 D HR secured refers to a form used for reporting information on health coverage.
Employers who provide health coverage to their employees are required to file 8272 D HR secured.
You can fill out 8272 D HR secured by providing the required information on the form, including details about the health coverage provided.
The purpose of 8272 D HR secured is to report information on health coverage provided by employers to their employees.
Information such as the name of the employer, the type of health coverage provided, and the number of employees covered must be reported on 8272 D HR secured.
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