Form 4214, Request for Non-Emergency Medical Transportation (NEMT) Services

Texas Health and Human Services

This government document is issued by Texas Health and Human Services for use in Texas

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File Details: PDF (87.2 KB)
Downloads: 13
Source
https://www.hhs.texas.gov/regulations/forms/4000-4999/form-4214-request-non-emergency-medical-transportation-nemt-services

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