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06/24/2024PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/CLIAAND PLAN OF CORRECTIONIDENTIFICATION
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Healthcare providers who are seeking to bill for services under specific insurance or government programs.
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Organizations or individuals that provide medical or health-related services that require reimbursement.
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Provider number 15g521 is a specific identification number assigned to a healthcare provider or organization for billing and regulatory purposes.
Healthcare providers and organizations that provide a specific type of service or treatment and are required to report information related to that service must file provider number 15g521.
To fill out provider number 15g521, providers must complete the required sections accurately, providing necessary information such as their organization details, service information, and any other specified data on the form.
The purpose of provider number 15g521 is to track and regulate healthcare services provided by organizations, ensuring compliance with applicable laws and facilitating billing processes.
Information that must be reported on provider number 15g521 includes the provider's name, address, type of services rendered, service dates, and relevant identification details.
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