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Printed: 11/26/2024 Form Approved OMB No. 09380391Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA
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Form Plaza Health Services is a document used for reporting health-related data and compliance with health service regulations.
Entities participating in health service programs or organizations providing health services and meeting specific criteria are required to file Form Plaza Health Services.
To fill out Form Plaza Health Services, provide accurate information as requested in each section, including entity details, healthcare data, and compliance measures, and ensure it is signed by an authorized individual.
The purpose of Form Plaza Health Services is to ensure compliance with health service regulations, facilitate data collection for health trends, and improve health service delivery.
Information reported on Form Plaza Health Services typically includes service volumes, patient demographics, financial data, and compliance with regulatory standards.
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