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Get 1490 S Form 2018-2024

DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESForm Approved OMB No. 09381197PATIENTS REQUEST FOR MEDICAL PAYMENT IMPORTANT: PLEASE READ THE ATTACHED INSTRUCTIONS.

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  1. Hit the orange Get Form option to begin filling out.
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  8. Select Done in the top right corne to export the record. There are various ways for receiving the doc. As an instant download, an attachment in an email or through the mail as a hard copy.

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