• MC 1054 (6/07): 메디칼(Medi-Cal) 비용 분담 제공자 안내문​​ 
• MC 1982 A (07/12) – SD/MC Quarterly Claim for Reimbursement – Treatment Cost​​ 
• MC 1982 B (07/12) – SD/MC 분기별 상환 청구 – 행정 비용​​ 
  대체: MC 1982 B (Excel)​​ 
• MC 1982 C (07/12) – SD/MC Monthly Claim for Reimbursement – Quality Assurance/Utilization Review (QA/UR) Cost​​ 
• MC 1982 D (07/12) – SD/MC 분기별 상환 청구 – 메디칼 행정 활동(MAA)​​ 
  대체: MC 1982 D – (Excel)​​