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Get DHS 1147 Instructions 2014-2024

R review, i.e. 3 month review to determine continued stay. 2. Patient Name: Self-explanatory. 3. Birthdate: Self-explanatory. 4. Gender: Indicate whether the patient is “M” for male or “F” for female. 5. Medicare: Check the appropriate box indicating whether patient has Medicare Part A and B and enter patient’s Medicare I.D. number, if eligible for either Part A or B. 6. Medicaid Eligible: Check “Yes” or “No” to indicate whether the patient is currently Medicaid eligi.

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