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NEW YORK STATE DEPARTMENT OF HEALTH Office of Health Insurance Programs Division of Managed Care Organization (MCO) Service Area Expansion Application Name of Applicant (last, first, middle initial)
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What is nysoh doh 5040 form?
The nysoh doh 5040 form is a specific form used by the New York State Department of Health (DOH).
Who is required to file nysoh doh 5040 form?
Healthcare providers and facilities in New York State are required to file the nysoh doh 5040 form.
How to fill out nysoh doh 5040 form?
To fill out the nysoh doh 5040 form, you need to provide relevant information about the healthcare services provided.
What is the purpose of nysoh doh 5040 form?
The purpose of the nysoh doh 5040 form is to collect data on healthcare services provided in New York State.
What information must be reported on nysoh doh 5040 form?
The nysoh doh 5040 form requires reporting of specific information about the healthcare services, such as diagnosis codes, procedure codes, and patient demographics.
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