Additional Information

Last updated	November 12, 2022
Created	December 11, 2021
Format	application/pdf
Form Number	https://forms.mgcs.gov.on.ca/dataset/11d55510-b41b-4704-8ead-8bf1cfcc3637/resource/7fee6484-0398-48b5-93fd-82a5533fd85a/download/4747-84e.pdf
Form File Identifier	4747-84
Name	English / French - 014-4747-84b - Application for IHP Claims Submission and Remittance Advice in Machine Readable Input (MRI)
Form File Status	Available
Description	IHPs requesting approval to submit their claims in MRI format
Language	English / French
Functionality	Fill and Print
Form File Content Type	Form
Remark
Edition Date	2022-11