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Optical of Utah Out of Network Reimbursement Request Insured Member Identification Number Insured Member's Full Name Insured Daytime Phone Number Insured Address Patient Name Date of Service Place
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Opticare of Utah is a form required to be filed by certain individuals or entities with the state of Utah.
Individuals or entities providing certain healthcare services in Utah are required to file Opticare of Utah.
Opticare of Utah can be filled out online through the designated portal on the state of Utah's website.
The purpose of Opticare of Utah is to report information related to healthcare services provided in the state.
Information such as details of healthcare services provided, patient demographics, and billing information must be reported on Opticare of Utah.
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