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IB 10430 Effective date: February 27, 20172017 Co-payment Rates Outpatient Services * Basic Care Services provided by a primary care clinician×15 / visitSpecialty Care Services provided by a clinical
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It is a form used for reporting financial information by certain entities.
Entities regulated by specific regulations.
By providing accurate financial information as outlined in the form.
To ensure transparency and compliance with financial regulations.
Financial information such as income, expenses, and assets.
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