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470-5480 Mileage Reimbursement Trip Log and Claim Form
Iowa Medicaid. Mileage Reimbursement Trip Log and Claim Form. Must be sent to: Access2Care. 405 SW 5th Street, Suite C. Des Moines, IA 50309-4609.
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DAILY VEHICLE MILEAGE AND FUEL REPORT
A Daily Vehicle Mileage and Fuel Report must account for all miles traveled and all fuel received. If you use a substitute vehicle, prepare a separate Daily
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Mileage Reimbursement Voucher
Mail completed form to: Or email to: The University of Iowa. USS-Education@uiowa.edu. University Shared Services. 224C Lindquist Center South. Iowa City, IA
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