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12/26/2018PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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121 form approved omb is a form approved by the Office of Management and Budget (OMB) for reporting financial information.
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Entities or individuals required by law or regulation to report their financial information.
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The form can be filled out electronically or manually following the instructions provided by the issuing agency.
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The purpose is to gather financial information for regulatory or oversight purposes.
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Financial transactions, assets, liabilities, and other relevant financial information.
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