AUTHORIZED PROVIDER. 18.1 TRICARE-PROVIDER STATUS On the effective date of the agreement, DHA recognizes the RTC as an authorized provider for the purpose of providing RTC care to TRICARE-eligible beneficiaries within the framework of the program(s) identified below. PROGRAM BEDS AGES Residential Treatment Center Name Expiration Date TRICARE Per Diem Rate DHA By: Signature By: Signature Name and Title Name and Title Executed on: Executed on:
Appears in 16 contracts
Samples: manuals.health.mil, manuals.health.mil, manuals.health.mil
AUTHORIZED PROVIDER. 18.1 TRICARE-PROVIDER STATUS On the effective date of the agreement, DHA recognizes the RTC as an authorized provider for the purpose of providing RTC care to TRICARE-eligible beneficiaries within the framework of the program(s) identified below. PROGRAM BEDS AGES Residential Treatment Center Name Expiration Date TRICARE Per Diem Rate DHA By: Signature By: Signature Name and Title Name and Title Executed on: Executed on:
Appears in 6 contracts
Samples: Participation Agreement, Participation Agreement, Participation Agreement
