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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CIA AND PLAN OF CORRECTION IDENTIFICATION NUMBER: 15G421
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How to fill out w0000 this visit was
How to fill out w0000 this visit was:
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Start by entering the date of the visit in the appropriate field.
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Next, provide the purpose of the visit in a clear and concise manner.
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Describe the activities or tasks accomplished during the visit, highlighting any important details or outcomes.
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