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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:15132411/29/2018FORM
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What is this visit was for?
This visit was for a medical examination required to assess a patient's health condition.
Who is required to file this visit was for?
Patients seeking medical consultations or examinations are required to file details regarding this visit.
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To fill out this visit, provide personal information, details of the visit, and the purpose of the consultation.
What is the purpose of this visit was for?
The purpose of this visit was to evaluate and diagnose health issues or to conduct routine health checks.
What information must be reported on this visit was for?
The report must include patient identification, date of visit, medical history, diagnosis, and treatment recommendations.
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