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AMERIGROUP OUTPATIENT TREATMENT REPORT FORM C AMERIGROUP District of Columbia TELEPHONE: 1 8004543730 Faxes: 1 8005051193 FILL OUT COMPLETELY TO AVOID DELAYS IDENTIFYING Outpatient\'s Name:Medicaid
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8004543730 is a form used for reporting certain information to the IRS.
Entities with specific financial transactions are required to file Form 8004543730.
You can fill out Form 8004543730 by providing the required information about the financial transactions.
The purpose of Form 8004543730 is to report certain financial transactions to the IRS.
Form 8004543730 requires reporting specific details about the financial transactions, such as amounts and dates.
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