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AMOUNT Receipts must be furnished for carrier s file Employee signature Carrier s approval Reimburse employee Yes no EMPLOYEE Mail your bill in duplicate promptly to employer and/or insurance carrier Reimburse drug store EMPLOYER OR CARRIER/ADMINISTRATOR DRUGS MAY BE REIMBURSED DIRECTLY TO THE EMPLOYEE OR DRUG STORE. IT IS NOT NECESSARY TO SUBMIT BILLS TO THE COMMISSION FOR APPROVAL. PAY AND RETAIN COPY IN CARRIER S FILE. FORM 25P 2/01 PAGE 1 OF .

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Keywords relevant to Form 25p

  • NCIC
  • Raleigh
  • ic
  • Helpline
  • reimbursed
  • itemized
  • gov
  • certify
  • reimburse
  • emp
  • furnished
  • Administrator
  • Provisions
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