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Hospital Statement of Cost BHF Page 1Healthcare and Family Services, Bureau of Health Finance, 201 S. Grand Ave. E., Springfield, IL 62763General InformationPreliminaryName of Hospital: Trinity Medical

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Gather all necessary information such as the date, time, services provided, and cost.

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Anyone who provides services or products to customers and needs to charge for those services or products.

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Billed ip refers to the invoice for internet protocol services provided by a telecom company.

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