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CSO1183A (317) ARIZONA DEPARTMENT OF CHILD SAFETY COMPREHENSIVE MEDICAL AND DENTAL PROGRAM GENERAL/PEDIATRIC DENTIST ORTHODONTIC TREATMENT REFERRAL MEMBERS NAME DATE OF BIRTH MDP/AHC CCS NO. MEMBERS
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CSO-1183A - General Pediatric is a form used to report pediatric healthcare services and patient data relevant to general pediatric care.
Healthcare providers and institutions that deliver pediatric services are required to file the CSO-1183A - General Pediatric form.
To fill out CSO-1183A - General Pediatric, providers must provide relevant patient data, including demographics, types of services rendered, and outcomes, as per the guidelines provided with the form.
The purpose of CSO-1183A - General Pediatric is to collect standardized data to improve pediatric care quality, monitor health outcomes, and facilitate research.
Information that must be reported includes patient demographics (age, sex), types of services provided, diagnosis codes, treatment outcomes, and any follow-up care requirements.
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