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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES MEDICARE/MEDICAID CERTIFICATION AND TRANSMITTAL ID: H3YY PART I TO BE COMPLETED BY THE STATE SURVEY AGENCY Facility
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id h3yy is a unique identification code assigned to a specific form or document.
Entities or individuals specified in the instructions of id h3yy are required to file it.
To fill out id h3yy, follow the instructions provided in the form and input the required information accurately.
The purpose of id h3yy is to gather specific information or data for a particular purpose.
The information required to be reported on id h3yy may include but not limited to: name, address, date, etc.
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