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You will receive a new ID number shortly. Date of Injury MM DDIY YYY Group KYHA Employee Date of Birth Atencion Trabajador Lesionado Este formulario de identificaci6n para servicios temporales de prescripci6n de recetas por compensaci6n del trabajador DEBERA SER PRESENTADO a su farmaceutico al surtir su s receta s inicial es. All correspondence and bills must be directed to UPMC WORK PARTNERS Cla im s Management Services PO Box 297 1 Pittsburgh PA 15230 Fax 412 454-8717 3. O. Box 2971...
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