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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CIA AND PLAN OF CORRECTION IDENTIFICATION NUMBER: 150038

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What is 4hc911 - state of?

4hc911 - state of is a form used to report on health care coverage for individuals.

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Employers or health insurance providers are required to file 4hc911 - state of.

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You can fill out 4hc911 - state of electronically or by mail following the instructions provided by the IRS.

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The purpose of 4hc911 - state of is to provide information on health care coverage to the IRS.

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You must report the names, social security numbers, and health care coverage information of individuals.

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