Attachment 95 – MPC Hospital Provider Overflow Patient List

Attachment 95 – MPC Hospital Provider Overflow Patient List.docx

Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC)

Attachment 95 – MPC Hospital Provider Overflow Patient List

OMB: 0935-0118

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OMB#: 0935-0118




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Medical Expenditure Panel Survey – Medical Provider Component


Reference #: «GID

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Confidential Patient Checklist – (Continued)
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Attachment 95 MPC Hospital Overflow Patient List











Provider Name

Pati7ent Name

Date of Birth

Gender

2017

Patient
Records Located

Patient Located -
No 2017 Records

Is Not
A Patient










































































































































































































File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorEdrina Bailey
File Modified0000-00-00
File Created2021-01-20

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