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Commonwealth of Virginia REQUEST FOR APPLICATIONS (RFA)Issue Date: September 25, 2020, Title: Pharmaceutical ProcessorsHealth Service Area I'm Issuing Agency:Department of Health Professions Virginia
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Forms 12VAC30-50-9999 is a Virginia Medicaid form used for reporting certain financial and operational data by Medicaid providers.
Medicaid providers in Virginia who provide services reimbursed by Medicaid are required to file this form.
To fill out the form, providers should follow the instructions provided with the form, ensuring all required information is accurately reported and submitted.
The purpose of the form is to collect necessary information from Medicaid providers to ensure compliance with state and federal regulations, and to support proper reimbursement for services rendered.
Providers must report financial details, operational data, and any other information required by the Virginia Department of Medical Assistance Services.
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