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I n t h e C o u r t o f C o m m o n P l e an s o f Y o r k C o u n t y, P e n n s y l v an n i a Plaintiff vs DRS Number Defendant PASSES ID Number CERTIFICATE OF SERVICE The undersigned hereby certified
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Request for unreimbursed medical is a formal application to seek reimbursement for medical expenses that were not covered by insurance or other means.
The individual who incurred the medical expenses is required to file a request for unreimbursed medical.
To fill out a request for unreimbursed medical, the individual must provide detailed information about the medical expenses incurred, including receipts and proof of payment.
The purpose of a request for unreimbursed medical is to request reimbursement for medical expenses that were not covered by insurance.
The request for unreimbursed medical must include details about the medical expenses incurred, proof of payment, and any other relevant documentation.
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