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OMB #: 0935-0118 PANEL 13 AUTHORIZATION TO OBTAIN INFORMATION FROM PHARMACIES AND PHARMACY RECORDS MEDICAL EXPENDITURE PANEL SURVEY U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES A. Provider Name: Street
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OMB0935 0118 form is a document used for reporting specific information to the Office of Management and Budget (OMB).
The specific individuals or entities required to file OMB0935 0118 form may vary depending on the purpose of the form. It is best to consult the instructions or guidelines provided by the OMB or the relevant authority to determine who must file the form.
Filling out OMB0935 0118 form typically involves providing the requested information in the designated fields or sections of the form. The specific instructions for filling out the form should be provided with the form itself or by the issuing authority. It is important to follow the instructions carefully and provide accurate and complete information.
The purpose of OMB0935 0118 form is to collect specific information for administrative purposes, data analysis, or regulatory compliance. The exact purpose can vary depending on the nature of the form and the requirements imposed by the issuing authority.
The specific information that must be reported on OMB0935 0118 form will depend on the purpose of the form. The form's instructions or guidelines provided by the issuing authority will outline the required information in detail. It is important to ensure that all necessary information is accurately and completely reported.
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