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What is form 4123?

Form 4123 is an optional form used by Texas Health and Human Services Commission (HHSC) staff and Home and Community-based Services (HCS) Waiver program providers to document a service event for the Registered Nurse, Specialized Registered Nurse, Licensed Vocational Nurse and Specialized Licensed Vocational Nurse service components.

How many billable service events can be entered on form 4123?

Form 4123 may be used for up to two separate billable service events. Each billable service event must be entered on a separate section. Additional supporting documentation for the Nursing Service Delivery Log is required for all service activities denoted by an asterisk (i.e., reports, assessments).

What is the weight of the Yueyang 4123 printer?

4123 Wi-Fi Corded Electric Tablet Inkjet Printer 1N, (Black Ink Cartridge 1N,Color Ink Cartridge 1N,Power Cord 1N,USB Cable 1N,User Manual 4N) Cal-Comp Optical Electronics YUEYANG Co 6 kg 190 g


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