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DATE - NY Motor Vehicle No-Fault Inurance Law Cover Letter
NYS FORM NF-3 (Rev 1/2004). Page 1 of 3. PROVIDERS NAME AND ADDRESS*. KINDLY COMPLETE AND SUBMIT THIS FORM AS SOON AS POSSIBLE. PLEASE NOTE, THIS COMPLETED.
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15 CSR 30-50.040 - Forms | State Regulations | US Law
PURPOSE: This rule prescribes the forms adopted and approved for filing with the commissioner. PUBLISHERS NOTE: The secretary of state has determined that
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Medicare
FORM CMS-2552-10. 4015.2 (Cont.) Column 4--Enter on lines 1 and 2 the amount in column 3, lines as applicable, divided by the amount in column 3, line 3.
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