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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15E28110/30/2012FORM
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The f0000 this visit was is a form used to report visit details.
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The purpose of f0000 this visit is to track and report visit information for record-keeping purposes.
Information such as visit date, time, location, purpose, and details of the visit must be reported on f0000 this visit.
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