To get a judicial review in federal district court, the amount of your case must meet a minimum dollar amount. For 2018, the minimum dollar amount is $1,600. You may be able to combine claims to meet this dollar amount. Follow the directions in the MAC's decision letter you got in level 4 to file a complaint.
You may want your doctor or other prescriber (for prescription drug appeals) to request this appeal on your behalf. If so, you’ll need to submit an “Appointment of Representative” form [PDF, 47.7KB].