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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES MEDICARE/MEDICAID CERTIFICATION AND TRANSMITTAL ID: QQ04 Facility ID: 23242 PART I TO BE COMPLETED BY THE STATE SURVEY
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What is id qq04?
Id qq04 is a unique identification number assigned to a specific form or document.
Who is required to file id qq04?
Individuals or entities specified in the instructions for id qq04 are required to file this form.
How to fill out id qq04?
Id qq04 can be filled out by following the instructions provided in the form and providing accurate information.
What is the purpose of id qq04?
The purpose of id qq04 is to collect specific information for regulatory or reporting purposes.
What information must be reported on id qq04?
Id qq04 requires reporting of specific data elements as outlined in the form instructions.
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