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EIDE Billy, LLP
ST. MARGARET\'S HOSPITAL
In Lieu of Form CMS255210
This report is required by law (42 USC 1395g; 42 CFR 413.20(b)). Failure to report can result in all interim FORM APPROVED
payments
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An in lieu of form is a substitute document or declaration submitted by a taxpayer instead of the standard form required by tax authorities.
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