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MAXIMUS FEDERAL SERVICES, INC. Independent Bill Review P.O. Box 138006 Sacramento, CA 958138006 Fax: (916) 6054280 Independent Bill Review Final Determination Reversed 9/18/2014IBR Case Number: Claim

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Step 1: Gather all the necessary information and documents required to fill out the form, such as the product details, unit measurements, and any relevant specifications.

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Step 2: Begin by entering the number '17002' in the designated field for the units.

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Step 3: Proceed to enter '22' in the field for the multiplier or the 'x' value.

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Step 4: Multiply the two numbers, 17002 and 22, to obtain the total units in the form.

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Step 6: Once confirmed, submit the completed form.

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