Examples of Amount Claimed in a sentence
Denied Provider Amount Claimed Amount Awarded Payable to Explanations of the application of the medical fee schedule, deductibles, co-payments, or other particular calculations of Amounts Awarded, are set forth below.
Not In Issue Provider Amount Claimed Amount Awarded Payable to Explanations of the application of the medical fee schedule, deductibles, co-payments, or other particular calculations of Amounts Awarded, are set forth below.
Is the claim in UAE?Name of Hospital/Dr. Yes No If No, precise Country Date of Treatment / / 1 Number of Invoices Total Amount Claimed CurrencyFor breakdown of Total Amount Claimed, use attached summary table cover sheet to tabulate entries in chronological order.
The Amount Claimed relates to the sums owed by 3CIF in application of article(s) [insert the number(s) of Article[s]] of the Conditions of the Securities [in the case of Securities issued under different issuance programmes, specify these programmes and their conditions].4.
Yes NoName and Address of Storage CompanyDate Moved to Storage (mm/dd/yyyy)Date Moved From Storage (mm/dd/yyyy)Expense Identification Amount Claimed For Agency Use Only Computation of Storage CostsItemAmountFor Agency Use Only Monthly Rate for Storage $ $ Number of Months in Storage Total Storage Costs (Include this amount in line (1) of Item 9, Total) $ $Description of Property Stored (List may be attached) Section D.