Attachment 95 – MPC Pharmacy Provider Authorization Form Package, Records to be Provided via Fax Anticipated

Attachment 95 MPC Pharmacy_Fax_AF_Packet.doc

Medical Expenditure Panel Survey - Household and Medical Provider Components

Attachment 95 – MPC Pharmacy Provider Authorization Form Package, Records to be Provided via Fax Anticipated

OMB: 0935-0118