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Health Financial SystemsMCRIF32FOR EUREKA HOSPITAL IN LIEU OF FORM CMS255296(04/2005) PREPARED 6/ 3/2011 6:47 FORM APPROVED OMB NO. 09380050THIS REPORT IS REQUIRED BY LAW (42 USC 1395g; 42 CFR 413.20(b)).

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00 - of reopenings refers to the process of officially reopening a case or issue that was previously closed or resolved.

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