Statement for Crime Victim Miscellaneous Services
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| Información del documento | ||
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| Título |
Statement for Crime Victim Miscellaneous Services (Un formulario electrónico)- 566 KB PDF) |
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| Descripción | Used by the provider or supplier for reimbursement of the following services - dental, glasses, home health, nursing home serivces, medical equipment, prosthetics-orthotics, transportation, vocational, retraining and other. |
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| Detalle | ||
| Número del formulario | F800-076-000 | |
| Disponibilidad | Online only | |
| Palabras claves | billing, bills, crime victims compensation, cvc, industrial insurance, nursing facility, physician, victim, worker's compensation, workers compensation, workers' compensation | |
| Idiomas | English | |
| Fechas válidas | 08-2009 | |
| Contacto |
Crime Victims Compensation
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| Páginas de Internet | Help for Crime Victims | |
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