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PRINTED: 05/04/2021 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION
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The 0504 form is a regulatory document used for reporting specific information required by the governing authority, typically related to financial or operational data.
Organizations or individuals who meet certain criteria set by the governing authority, often related to specific industries or business activities, are required to file the 0504 form.
To fill out the 0504 form, follow the instructions provided by the governing authority, ensuring that all required fields are completed accurately with the necessary information.
The purpose of the 0504 form is to collect data that assists in regulatory oversight, compliance, and analysis of specific activities or financial transactions.
The 0504 form typically requires information such as financial statements, operational data, and any relevant compliance details as specified in the filing guidelines.
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