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Total Healthcare Solutions LLC 7048 Old Canton Rd Ste 2E | Ridgeland, MS 39157 Phone: 601.919.0972 | Toll Free: 866.919.0972 Fax Completed Forms To: 601.919.0974 Patient Name:DOB:Ht:Address:City:Phone:SS#:Wt:Waist:

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Patients who require a back brace prescribed by Total Healthcare.

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What is back-brace-cmn-formpdf - total healthcare?

back-brace-cmn-formpdf - total healthcare is a form used to report information related to back braces and total healthcare services.

Who is required to file back-brace-cmn-formpdf - total healthcare?

Healthcare providers and facilities that provide back braces and total healthcare services are required to file back-brace-cmn-formpdf - total healthcare.

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To fill out back-brace-cmn-formpdf - total healthcare, providers need to enter detailed information about the back brace services provided and total healthcare treatments administered.

What is the purpose of back-brace-cmn-formpdf - total healthcare?

The purpose of back-brace-cmn-formpdf - total healthcare is to track and report back brace services and total healthcare treatments for regulatory and reimbursement purposes.

What information must be reported on back-brace-cmn-formpdf - total healthcare?

Information such as patient demographics, diagnosis codes, treatment dates, and the specifics of the back brace services and total healthcare treatments must be reported on back-brace-cmn-formpdf - total healthcare.

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