%PDF-1.3
%
1 0 obj
<>]/Pages 3 0 R/Type/Catalog/ViewerPreferences<>>>
endobj
2 0 obj
<>stream
2021-03-30T17:03:01-04:00
2021-03-30T17:03:02-04:00
2021-03-30T17:03:02-04:00
Adobe InDesign 15.0 (Windows)
uuid:562cb03d-f955-408d-9a38-778d842818bf
xmp.did:276ceb04-3d83-407e-996f-cd8fb8e194c5
xmp.id:7ed41605-6bd6-8b47-9e73-fd9327092322
proof:pdf
1
xmp.iid:946d7422-c56b-9b42-a415-415e847efab2
xmp.did:8473b462-93d7-a648-a3d1-d69f5d9472bc
xmp.did:276ceb04-3d83-407e-996f-cd8fb8e194c5
default
converted
from application/x-indesign to application/pdf
Adobe InDesign 15.0 (Windows)
/
2021-03-30T17:03:01-04:00
application/pdf
69121-16 Doctors Office Claim Form.indd
Adobe PDF Library 15.0
False
PDF/X-1:2001
PDF/X-1:2001
PDF/X-1a:2001
endstream
endobj
3 0 obj
<>
endobj
5 0 obj
</LastModified/NumberofPages 1/OriginalDocumentID/PageUIDList<0 381>>/PageWidthList<0 612.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text]/Properties<>/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
6 0 obj
</LastModified/NumberofPages 1/OriginalDocumentID/PageUIDList<0 554>>/PageWidthList<0 612.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
7 0 obj
</LastModified/NumberofPages 1/OriginalDocumentID/PageUIDList<0 582>>/PageWidthList<0 612.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
9 0 obj
</LastModified/NumberofPages 1/OriginalDocumentID/PageUIDList<0 698>>/PageWidthList<0 612.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
24 0 obj
<>stream
HWn}WS ͋DI` -N0"i4`?>U]MllE.Nzy|uvkOܵ/|m5`#6ؗ_e$uQWy\_rwb:g"bW\L4̃}i?8`%歈F4_@q\ú0UOԒҁp>4SJ\ĕ<9+0m!na1<9>aފ<M=f_tlpn^;qZ\?os|zϳuSO|=[zO5͛䡋}ͧ>y{xywO8a-:M!@͊Q#X[eE2~
`\>rćzYq`-6뵻ݬzqk fa٣c<;XۓvzW˂Y +khB} zFEVt= ;1xF|_%öbsW;(ML|r -ڱW"8
=UU%s@/PV["˞N)i1U>
AYr2Brwr!
^zFvPLZl o;EPp";Q3
R O%mȤp^-q^ 6zaa;UTh I[I؊uSjt令3b=,ٍZRͰ'Uw Hbsr<ǜo0$uqR<]Ex[fi[Wb^HNB;8!.1xߍ#'wCŅ?,oWJ3"87 H6)j
jZuѾGn_yQ^SDaɤoE4EHpp.D)/*,YUkmCiY֔P34EEY? ]D?UAPʵI;'$Tv^fvv&"7#t#:)zsЀ39e8@s\bvAtH=Sg_j\1ua= $UU"}\ 8KCD;M.sV\Ega&,hB_O^p{")
~YrѱR3ɘ:
2 E˪vA,9