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December 2016 Texas Medicaid Provider Procedures Manual

Section 6: Claims Filing : 6.9 Family Planning Claim Form (Paper Billing) : 6.9.1 2017 Claim Form

6.9.1
A copy of a blank 2017 Claim Form and copies of example completed claim forms are available on the Claim Form Examples page of the TMHP website at www.tmhp.com.

Texas Medicaid & Healthcare Partnership
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