Dhia mus rau cov ntsiab lus​​ 
Tsev Cov Chaw Muab Kev Pabcuam & Cov Neeg Koom Tes Cov Ntawv Them Nqi Rau Kev Ua Haujlwm ntawm Medi-Cal hauv Tsev Kawm Ntawv​​ 

Cov Nqi Them Nqi Kawm Ntawv raws li Medi-Cal Kev Tswj Xyuas Kev Ua Haujlwm​​ 

Rov qab mus rau SMAA Home Page​​ 

Tam sim no Invoice​​ 

  • For current version of the template, please email us at SMAA@dhcs.ca.gov.​​ 

Daim ntawv Invoice​​