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In s 16 _ Ar m 34 _ Pr o vid er q u est ion n a ir e _F U 1 3M _ E N Ph ase 2 Pr i m ar y He al th C ar e Pr ov id er Qu e st ion n a ir ePractice details and date Provider ID (preprinted) Date (Day/Month/Year)

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Section 16 AR is a specific form required for reporting certain financial information to a regulatory body, often related to tax compliance.

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