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Forms - Part B

Home MAC Provider Medicare Areas Enrollment Part B Forms

Electronic CMS 855 Forms Available

CMS 855 Medicare Enrollment Applications link to website outside of wpsmedicare

CMS 460 Medicare Participating or Supplier Agreement adobe portable format

CMS 588 Electronic Funds Transfer (EFT) Authorization Agreement adobe portable format

EDI Enrollment Form External PDF

Page Last Updated: Thursday, 13-Nov-2008 09:57:31 CST

 

 

 

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