French - 014-2784-87 - Drug Benefit Claim...
Dataset description:
Used by pharmacies for submitting claims
Additional Information
| Last updated | November 26, 2022 |
|---|---|
| Created | December 11, 2021 |
| Format | application/pdf |
| Form Number | https://forms.mgcs.gov.on.ca/dataset/af50f133-dc63-4105-842f-b41f678abc0f/resource/904ec54a-a58b-4c33-8be6-e4353b5de4a9/download/2784-87f.pdf |
| Form File Identifier | 014-2784-87F |
| Name | French - 014-2784-87 - Drug Benefit Claim Submission Form |
| Form File Status | Available |
| Description | |
| Language | French |
| Functionality | Fill and Print |
| Form File Content Type | Form |
| Remark | |
| Edition Date | 2022-11 |
