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Revision: HCFAPM8620 SEPTEMBER 1986 (BERG) State/Territory: ATTACHMENT 3.1B Page 1 OMB No.: 09380193 South Carolina AMOUNT DURATION AND SCOPE OF SERVICES PROVIDED MEDICALLY NEEDY GROUP(S): The following
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Revision hcfa-pm-86-20 berc attachment is a form used for reporting specific information related to healthcare billing and reimbursement.
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Revision hcfa-pm-86-20 berc attachment should be filled out with accurate and detailed information as per the instructions provided on the form.
The purpose of revision hcfa-pm-86-20 berc attachment is to ensure proper documentation and reporting of healthcare billing and reimbursement data.
Information such as patient demographics, services provided, charges, payments, and adjustments must be reported on revision hcfa-pm-86-20 berc attachment.
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