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Form 4116-DME Icf / Iid Durable Medical Equipment Summary Sheet - Texas
What Is Form 4116-DME?
This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 4116-DME Icf/Iid Durable Medical Equipment Summary Sheet?A: Form 4116-DME Icf/Iid Durable Medical Equipment Summary Sheet is a document used in Texas.
Q: What is the purpose of Form 4116-DME Icf/Iid Durable Medical Equipment Summary Sheet?A: The purpose of this form is to provide a summary of durable medical equipment used at an Icf/Iid facility in Texas.
Q: Who uses Form 4116-DME Icf/Iid Durable Medical Equipment Summary Sheet?A: This form is used by Icf/Iid facilities in Texas that provide medical equipment to their residents.
Q: What information is included in Form 4116-DME Icf/Iid Durable Medical Equipment Summary Sheet?A: The form includes information such as the name and address of the facility, a list of durable medical equipment items, the date of service, and the cost of each item.
Q: How is Form 4116-DME Icf/Iid Durable Medical Equipment Summary Sheet submitted?A: The completed form is usually submitted to the appropriate state agency or organization responsible for overseeing Icf/Iid facilities in Texas.
Form Details:
- Released on August 1, 2007;
- The latest edition provided by the Texas Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 4116-DME by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
