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MAXIMUS FEDERAL SERVICES, INC.
Independent Bill Review
P.O. Box 138006
Sacramento, CA 958138006
Fax: (916) 6054280INDEPENDENT BILLING REVIEW FINAL DETERMINATION
December 18, 2014IBR Case Number:
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What is upheld and form claim?
Upheld and form claim is a formal document submitted to report a claim that has been approved and upheld by the relevant authority.
Who is required to file upheld and form claim?
The individual or organization who has had their claim approved and upheld is required to file the upheld and form claim.
How to fill out upheld and form claim?
The upheld and form claim must be filled out with accurate and detailed information about the approved claim, including supporting documentation.
What is the purpose of upheld and form claim?
The purpose of the upheld and form claim is to officially report that a claim has been approved and upheld, and to provide necessary information for processing.
What information must be reported on upheld and form claim?
The upheld and form claim must include details of the approved claim, such as the claimant's name, claim number, amount approved, and any other relevant information.
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