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Web What Is This Form For?

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Web We Are Authorized By Cms, Champus And Owcp To Ask You For Information Needed In The Administration Of The Medicare, Champus, Feca, And Black Lung Programs.

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Because This Form Is Used By Various Government And Private Health.

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In Order To Increase Health Care Provider Participation In The Workers' Compensation System And Improve Injured Workers' Access To Timely, Quality Medical.

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