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Get IN Medicaid Cost Report 1999-2024

OTAL Line No. 11 12 (17) (18) (19) (20) 13 Line No. 14 15 16 17 18 19 Expense (25) BENEFITS Adjustments (26) Page 4 TOTAL (27) T O T A L V A C A T I O N, S I C K, HOLIDAY HOURS PAID Employee Contract Adjustments TOTAL (21) (22) (23) (24) Indiana Medicaid Cost Report Home Health Agencies Agency Costs Name of Agency Medicaid Provider Number Schedule 3 - Adjustments to Operating Expenses For All Agencies Total Expenses from Income Statement Adjustments to Total Expenses Excess Fu.

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