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Form # |
CMS 29 |
Form Title |
REQUEST TO ESTABLISH ELIGIBILITY TO PARTICIPATE IN HI FOR AGED/DISABLED TO PROVIDE RURAL HEALTH CLINIC SERVICES |
Revision Date |
05/01/1978 |
O.M.B. # |
0938-0074 |
O.M.B. Expiration Date |
12/31/2008 |
CMS Manual |
N/A |
Special Instructions |
N/A |
| Downloads | CMS 29 (449 KB)
| Related Links Inside CMS | There are no Related Links Inside CMS
| Related Links Outside CMS | | There are no Related Links Outside CMS
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Last Modified Date : 04/23/2008
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