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Cms 724  Form

Cms 724 Form

Use a cms 724 template to make your document workflow more streamlined.

Year B10 C. Medicare/Medicaid Billings B11 Treatment Program for Psychiatric patients under the age of 22 Billed Collected MEDICARE/Part A MEDICAID B12 13. Current Hospital Statistics on days of survey certified beds only Name of Ward Bed Capacity Patient Census Total Patient Census Form CMS-724 09/94 B13 Page 1 Dates of Survey beginning / / mm day year B14 Administrator Nurse Dietician Pharmacist Social Worker LSC Specialist Sanitarian Physician Psychologist Other Initial B16 Recertification...
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