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Directory Results for UTAH MEDICAID DISCLOSURE OF OWNERSHIP AND CONTROL ... to Utah Medicaid Provider Manual CMS-1500 Instructions Division of Health Care Financing Updated October 2006 Instructions for CMS-1500 Claim The explanation for the CMS-1500 Claim Form is available from the insurance com m issioner

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UTAH MEDICAID NURSING FACILITY State Fiscal Year 2016 QUALITY IMPROVEMENT INCENTIVE (2)(iv) APPLICATION Patient Life Enhancing Devices, Rule R4145044 This and all supporting documentation must be postmarked or faxed on or before May -
UTAH MEDICAID NURSING FACILITY State Fiscal Year 2016 QUALITY IMPROVEMENT INCENTIVE (2)(vi) APPLICATION Vans and Van Equipment, Rule R4145044 This and all supporting documentation must be postmarked or faxed on or before May 31, 2016 -
UTAH MEDICAID NURSING FACILITY State Fiscal Year 2016 QUALITY IMPROVEMENT INCENTIVE (2)(viii) APPLICATION HVAC, Rule R4145044 This and all supporting documentation must be postmarked or faxed on or before May 31, 2016 Facility Name: -
UTAH MEDICAID NURSING FACILITY State Fiscal Year 2016 QUALITY IMPROVEMENT INCENTIVE (2)(X) APPLICATION OutcomeProven Awards, Rule R4145044 This and all supporting documentation must be postmarked or faxed on or before May 31, 2016 - -
UTAH MEDICAID NURSING FACILITY State Fiscal Year 2016 QUALITY IMPROVEMENT INCENTIVE (2)(xi) APPLICATION Worker Immunization, Rule R4145044 This and all supporting documentation must be postmarked or faxed on or before May 31, 2016 - -
UTAH MEDICAID NURSING FACILITY State Fiscal Year 2016 QUALITY IMPROVEMENT INCENTIVE (2)(xii) APPLICATION Patient Dignity Devices, Rule R4145044 This and all supporting documentation must be postmarked or faxed on or before May 31, 2016
UTAH MEDICAID NURSING FACILITY State Fiscal Year 2016 QUALITY IMPROVEMENT INCENTIVE (3) APPLICATION Rule R4145044 This and all supporting documentation must be postmarked or faxed on or before May 31, 2016 Facility Name: Medicaid - - -
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