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Third-Party Liability (TPL)/Medicare Special …
provider.indianamedicaid.comThird-Party Liability (TPL)/Medicare Special Attachment Form Instructions 1 Version 2.1, August 2017 Payer Seq Required.Relates to payer identified in section 3.
Indiana Health Coverage Programs
provider.indianamedicaid.comThird-Party Liability (TPL)/Medicare Special Attachment Form 1 Version 1.0, October 2016 (Introduction updated August 2017) Indiana Health Coverage Programs