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I ordered dispensers of various types, got it shipped really fast... a happy customer.

James

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Hospice 90 Day Certification/Re-Certification

Out of stock
SKU
MPSBRG-3463/2P
More Information
Brand Sage
MPN 3463/2P
Packaging 1 per each
Size 8-1/2In x 11In
$83.40

Hospice providers can use this to obtain the 90 day certification or recertification for hospice benefits.

  • Initial 90-day (Period I) authorization and Period II
  • Periods III and after use Briggs form 3443/2P

Color:White/Canary with Black Ink
Size:8-1/2" x 11", Detached
Hole Punch:5 holes on top and left side
Printed:2 part carbonless snap set
Quantity:100 ea/pk (Also sold in a case of 20 pk/ca)
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