La Care Pdr Form. Web mail the completed form to: Provider dispute resolution (pdr) form.
La Care Health Plan Pdr Form
Provider dispute resolution (pdr) form. *provider tax id # /. Web mail the completed form to: Web mail the completed form to: Care claims department / appeals and pdr unit p. Web for lasalle medical associates provider manual, click. Box 570590 tarzana, ca 91357 *provider name:
Provider dispute resolution (pdr) form. Web for lasalle medical associates provider manual, click. Web mail the completed form to: Box 570590 tarzana, ca 91357 *provider name: Provider dispute resolution (pdr) form. Care claims department / appeals and pdr unit p. Web mail the completed form to: *provider tax id # /.
