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The mileage rate is 65.5 cents ($0.655) per mile. Mileage for reasonable travel to the pharmacy, parking, bridge tolls, public transportation and other travel-related costs are also included. Complete this form. Attach receipts. Send the original to the insurance company and keep a copy.
Millas por un viaje de distancia razonable a la farmacia, estacionamiento, pago de peajes, transporte público y otros viajes y costos relacionados están también incluidos. Complete este formulario y adjunte los recibos. Envíe la forma original a la compañía de seguros y guarde una copia.
Mileage Worksheet for Medical Reimbursement 2023. This form allows FSA participants to request reimbursement for mileage and parking expenses incurred during medical visits. To ensure proper reimbursement, users must fill out the required information and attach evidence of mileage.
Mileage for reasonable travel to the pharmacy, parking, bridge tolls, public transportation and other travel-related costs are also included. Complete this form.
Pharmacy. California has a relatively lenient medical mileage policy compared to other states, but nothing’s a given. An experienced workers’ compensation attorney can help when the insurance carrier questions the submitted expenses. Rates Change Regularly. Mileage reimbursement rates vary depending on when you have traveled.
16 lut 2023 · Track mileage reimbursements effortlessly with our free mileage reimbursement form. Available in PDF, Word, Excel, and Google formats. Get started by downloading, customizing, and printing yours today.
For mileage that occurs in 2023, the rate is 65.5 cents per mile. Use this form to claim your mileage or travel reimbursement by sending a completed copy to your claim examiner.
