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Forms: MC 1000
MC 1054 (6/07): Share-of-Cost Medi-Cal Provider Letter
MC 1982 A (07/12) - SD/MC Quarterly Claim for Reimbursement - Treatment Cost
MC 1982 B (07/12) - SD/MC Quarterly Claim for Reimbursement - Administrative Cost
Alt:
MC 1982 B (Excel)
MC 1982 C (07/12) - SD/MC Monthly Claim for Reimbursement - Quality Assurance/Utilization Review (QA/UR) Cost
MC 1982 D (07/12) - SD/MC Quarterly Claim for Reimbursement - Medi-Cal Administrative Activities (MAA)
Alt:
MC 1982 D - (Excel)
Last modified date: 9/6/2022 10:16 AM
