CMS013070 | Centers for Medicare & Medicaid Services

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Form #: CMS 1541B
Form Title: RESPONSIBILITIES OF MEDICARE PARTICIPATING HOSPITALS IN EMERGENCY CASES INVESTIGATION REPORT
Revision Date: 04/01/1995
O.M.B. #: EXEMPT
O.M.B. Expiration Date: N/A
CMS Manual: N/A
Special Instructions: N/A

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CMS 1541B (417 KB) [PDF, 416KB]

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