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EXHIBIT 249 (Rev. 30, 121507) MODEL APPLICATION LETTER NOTIFYING TRANSPLANT HOSPITAL THAT A COMPLETE MEDICARE GENERAL ENROLLMENT HEALTH CARE FORM CMS855ANEEDS TO BE COMPLETED (Date) Transplant Hospital

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{ "answer": "Som - exhibit 249 is a form that is required to be filed by certain individuals or entities to report specific information to the relevant authority." }

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{ "answer": "Individuals or entities specified by the authority are required to file som - exhibit 249." }

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{ "answer": "Som - exhibit 249 can be filled out by providing the required information accurately and submitting it through the designated method specified by the authority." }

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{ "answer": "The purpose of som - exhibit 249 is to gather specific information from relevant parties for regulatory or compliance purposes." }

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{ "answer": "Information such as financial data, transaction details, or any other specific information requested by the authority must be reported on som - exhibit 249." }