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enrolled dispensing provider is located;

(B) the item or service is unavailable from a provider enrolled under 7 AAC 120.300 in the municipality where the recipient resides;

(C) the submitted claim and supporting documents include the

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Official source

enrolled dispensing provider is located;

(B) the item or service is unavailable from a provider enrolled under 7 AAC 120.300 in the municipality where the recipient resides;

(C) the submitted claim and supporting documents include the

(ii)address to where the item was delivered;#

(ii) address to where the item was delivered;

(iii) itemized list of the products included in the shipment or delivery, to include each product name, each product identifier, the quantity, and the serial number, when applicable;

(iv) shipment and delivery date;

(v) recipient’s signature with the date of receipt; and

(vi)total shipping and delivery charges minus all…#

(vi) total shipping and delivery charges minus all discounts, substantiated by a paid shipping invoice reflecting the actual payment;

(3) from the recipient to the dispensing provider for the repair of recipient-owned equipment when the following conditions apply:

(A) the recipient resides outside the municipality where the business of the enrolled dispensing provider is located;

(B) the item or service is unavailable from a provider enrolled under this section in the municipality where the recipient resides;

(C) the submitted claim and supporting documents include the

(i) address to where the item was delivered;

(ii) itemized list of the products included in the shipment or delivery, to include each product name, each product identifier, the quantity, and the serial number, when applicable;

(iii) shipment and delivery date;

(iv) recipient’s signature with the date of receipt; and

(v) total shipping and delivery charges minus all discounts, substantiated by a paid shipping invoice reflecting the actual payment;

(4) shipping costs that qualify for coverage under this section due to the recipient traveling within or outside of this state; those costs are eligible for coverage only if the recipient is traveling for medical, educational, or vocational reasons; documentation from the prescribing physician supporting the recipient’s reason for travel and including the estimated duration of travel must be submitted with the claim; shipping costs related to recreational travel are not