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Revision: HCFAPM8810 (BERG) SEPTEMBER 1988 Page 79b STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT MEDICAL ASSISTANCE PROGRAM State/Territory: SOUTH DAKOTA SECTION 4. GENERAL PROGRAM ADMINISTRATION
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Information such as patient details, services provided, costs, and billing codes must be reported on revision hcfa-pm-88-10 berc page.
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