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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:15516601/06/2015FORM
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This visit was for a routine health check-up to assess overall well-being.
Individuals seeking health services or monitoring certain health conditions are required to file for this visit.
To fill out this visit, provide personal identification, details of health concerns, and any previous medical history.
The purpose of this visit was to monitor health status, identify potential issues early, and provide preventive care.
Information such as personal details, health history, symptoms, and any medications being taken must be reported.
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