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Hospital Statement of Cost BHF Page 1 Healthcare and Family Services, Bureau of Health Finance, 201 S. Grand Ave. E., Springfield, IL 62763 General Information PRELIMINARYRevised 09/02/2011 Name of
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What is name of hospital?
The name of the hospital is XYZ Hospital.
Who is required to file name of hospital?
The hospital administrator or designated representative is required to file the name of the hospital.
How to fill out name of hospital?
The name of the hospital must be filled out on the designated form provided by the regulatory body.
What is the purpose of name of hospital?
The purpose of providing the name of the hospital is for identification and regulatory purposes.
What information must be reported on name of hospital?
The name of the hospital, address, contact information, and licensing information must be reported.
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