VA Form 10-10143b Screenshot

VA Form 10-10143b (Statement Question #1c on Documentation - TriWest).msg.PNG

EXPANDED ACCESS TO NON-VA CARE THROUGH THE VETERANS CHOICE PROGRAM, OMB 2900-AP24

VA Form 10-10143b Screenshot

OMB: 2900-0823

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2900-0823 can be found here:

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