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Health Financial SystemsMCRIF32FOR MENDOZA COMMUNITY HOSPITAL IN LIEU OF FORM CMS255296(04/2005) PREPARED 7/ 1/2010 10: 3 FORM APPROVED OMB NO. 09380050THIS REPORT IS REQUIRED BY LAW (42 USC 1395g;
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An IF services are identified by a unique identifier assigned to them.
Any entity providing IF services is required to file if services identified by.
To fill out if services identified by, the entity must provide all relevant information about the IF services.
The purpose of if services identified by is to track and monitor the provision of IF services.
The information reported on if services identified by includes details about the type and quantity of IF services provided.
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