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Get the free 20.2.1 - Admission Questions to Ask Medicare ... - CMS

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Patient Name Date of Birth / / Month DayYearPRINTMedicare Secondary Payer Questionnaire PRINT (Short Form) Medicare Secondary Payer Questionnaire The information contained in this form is used by
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2021 - admission questions typically refer to the questions asked during the admissions process for a specific year.
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