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Information Memorandum Transmittal Division of Medical Assistance Programs Alice Blavatsky, MAP Operations Manager Authorized Signature Topic: Number: DMAPIM08188 Issue Date: 12/04/2008 Medical Benefits
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The dmap im 08-188 provider is a form used for reporting information regarding provider services under the DMAP program.
Providers participating in the DMAP program are required to file the dmap im 08-188 provider form.
The dmap im 08-188 provider form can be filled out online or by mail with the required information on the services provided.
The purpose of the dmap im 08-188 provider form is to report data on the services provided to individuals under the DMAP program.
Information such as the provider's name, services provided, dates of service, and billed amount must be reported on the dmap im 08-188 provider form.
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