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Ning algorithm must be completed to use this form. Physician FIN screening algorithm: Conditions for using this short form If patient does not meet the criteria below, then the you are required to complete the long form History/Physical/Evaluation History/Physical/Evaluation - adult (X05716). Is patient 75 years old or greater? No Yes If yes, then stop and complete the long form History/Physical/ Evaluation History/Physical/Evaluation - adult (X05716). I.

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