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Form Approved OMB No. 09380679 Expires 02/2020DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESCERTIFICATE OF MEDICAL NECESSITY CMS484 OXYGEN DME 484.5SECTION A: Certification
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The form approved OMB number refers to a form that has been authorized by the Office of Management and Budget, indicating it has met requirements for clarity and efficiency in reporting.
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