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REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION This form may be sent to us by mail or fax: Address: P.O. Box 340 Tulsa, Ok 741010340 Fax Number: 9188794309 You may also ask us for a
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What is this form may be?
This form may be a tax return form.
Who is required to file this form may be?
Individuals or businesses meeting certain criteria may be required to file this form.
How to fill out this form may be?
This form may be filled out by providing accurate and complete information as requested.
What is the purpose of this form may be?
The purpose of this form may be to report financial information to the relevant tax authorities.
What information must be reported on this form may be?
Information such as income, expenses, deductions, and credits may be required to be reported on this form.
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