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Form Number: FORM 100.0 Form Name: 150 GRAM CARBOHYDRATE DIET Effective Date: 15 Aug 2012-Page 1 of 1 Your Health Care Provider has requested a Glucose Tolerance Test be performed. A 150gram carbohydrate

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Minimum - dthccapmedmil is a form that needs to be filled out to report minimum health care coverage information.

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Employers offering health care coverage and individuals who have minimum essential coverage are required to file minimum - dthccapmedmil.

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The purpose of minimum - dthccapmedmil is to report information about the minimum essential health care coverage provided to individuals.

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Information such as the name, address, and Social Security Number of the individual receiving health care coverage must be reported on minimum - dthccapmedmil.