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  INSTRUCTIONS. Please answer each question. clearly and completely. Type or print in ink. Read carefully and follow all direction. UNITEDNATIONS. PERSONAL HISTORY

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  This section contains five-character HCPCS Level II (national), interim codes, and three or four-character Health Insurance Portability and Accountability Act (HIPAA)-compliant revenue codes used for billing.

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  Entry Criteria Factors that must be present to enable the start of the

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• [DOCX File]www.uab.edu

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  Manual of Operations Version 5.0. Appendix A: Adverse Event Definitions . Version Date: 2/4/2016. Page 2 of 13

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• [XLSX File]omma.ok.gov

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  0.3. 0.3. 0.2. 0.2. 1. Role Last Name First Name Member Manager Owner Other Oklahoma Resident (Y/N) OSBI Report Affidavit of Lawful Presence Proof of Residency John

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