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CMS Addendum E Inpatient Only List
Heart & Vascular
Labor & Delivery
Surgery and Special Procedures
Authorization to Release Medical Information Forms
Note: The form can faxed to 919-350-7985 or mailed to: Medical Record Services - ROI, 3000 New Bern Avenue, Raleigh NC 27610
These forms are printed by WakeMed and can be ordered online and mailed to your practice in bulk at no charge.
Physician Office Orders
3000 New Bern Ave.
Raleigh, NC 27610