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Get OK MSPRC-Fixed Percentage

Payment will be ______________ which is 25% of my total settlement amount. (Note: Do not reduce the total settlement amount for attorney fees and costs.) Beneficiary Name:______________________ Date of Incident: ___________________ Medicare Number:______________________ Date of Settlement: _________________ Brief Description of Injuries: ___________________________________________________________ ___________________________________________________________________________________ ________________.

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Keywords relevant to OK MSPRC-Fixed Percentage

  • medicare
  • waiver
  • judgments
  • beneficiary
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