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Get TX Form 8603 2012

Tion Management and Review, IDD Waivers; Program Enrollment/Utilization Review (PE/UR) Mailing Address: Physical Address: P.O. Box 149030, Mail Code W-355 701 West 51 Street, Mail Code W-355 Austin, TX 78714-9030 Austin, TX 78751-4015 st Fax: 512-438-4249 (Do not fax more than 25 pages without prior approval.) Date Submitted Program Type: (check one) Intermediate Care Facilities/Intellectual Disability (ICF/ID) Home and Community-based Services (HCS) From: Provider Name Component Code.

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Keywords relevant to TX Form 8603

  • C12
  • C68
  • idd
  • 2012
  • ICAP
  • c20
  • utilization
  • applicable
  • waivers
  • submitting
  • enrollment
  • Intermediate
  • ur
  • medicaid
  • specify
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