
Get the free CaPDMERequestFormSOUTH 01252013. 270/271 Companion Guide - 5010
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SUBJECT: Reimbursement of Capital and Direct Medical Education Costs Dear Provider: TRI CARE authorizes Contractors of Managed Care Support Contracts to reimburse hospitals for allowed Capital and
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Enter the date: The form may require you to provide the date of the request. Make sure to write the correct date in the specified format (01252013).
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