Biểu mẫu: MC 1000
- MC 1054 (6/07): Thư của Nhà cung cấp Medi-Cal Chia sẻ Chi phí
- MC 1982 A (07/12) – SD/MC Quarterly Claim for Reimbursement – Treatment Cost
- MC 1982 B (07/12) – SD/MC Quarterly Claim for Reimbursement – Administrative Cost
Alt: 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 Quarterly Claim for Reimbursement – Medi-Cal Administrative Activities (MAA)
Alt: MC 1982 D – (Excel)