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Table of Contents State/Territory Name: Utah State Plan Amendment (SPA) #: 210012 This file contains the following documents in the order listed: 1) Approval Letter 2) CMS Form 179 3) Approved SPA

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What is medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012?

The medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012 is a form used by physicians to report information to Medicaid.

Who is required to file medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012?

Physicians who provide services to Medicaid patients are required to file the medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012.

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The medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012 form can be filled out electronically or by hand, following the instructions provided by Medicaid.

What is the purpose of medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012?

The purpose of the medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012 form is to gather information about services provided to Medicaid patients by physicians.

What information must be reported on medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012?

The medicaidmsgov ms-spa-21-0012-physicianms spa 21-0012 form requires reporting of services provided, patient information, and billing details.

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