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> Figure 4-5. DA Form 3156 (Statement of MSA Accountable Patient Days and Reimbursements Earned). - Patient Accountability Branch
Figure 4-4. DA Form 3155 (MSA Cash Record). - Patient Accountability Branch
Figure 4-6. DD Form 1131 (Cash Collection Voucher). - Patient Accountability Branch
Patient Accountability Branch
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Figure
4-5.
DA
Form
3156
(Statement
of
MSA
Accountable
Patient
Days
and
Reimbursements
Earned).
MD0752
4-8