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DR (01/02) IN THE COMMON PLEAS COURT OF MONTGOMERY COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS Name: Address: Plaintiff/Petitioner Case No. SETS No. Judge Oblige vs/and Name: Address: Defendant/Petitioner
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DR 0102 - MCOhio is a form used for reporting Medicaid Managed Care Organization (MCO) enrollment and payment information in Ohio.
Medicaid Managed Care Organizations (MCOs) operating in Ohio are required to file DR 0102 - MCOhio.
DR 0102 - MCOhio can be filled out electronically or manually by providing enrollment and payment information for Medicaid Managed Care Organizations.
The purpose of DR 0102 - MCOhio is to accurately report Medicaid Managed Care Organization enrollment and payment data for regulatory purposes.
DR 0102 - MCOhio requires reporting of Medicaid Managed Care Organization enrollment figures and payment details.
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Relevant keywords

OHIO arrearage Oblig affiants Obligee Affiant waives applicable subscribed PLEAS herein Petitioner Spousal Notary correcting Expires audit duly AFFIDAVIT

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