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Supporting Statement 1240-XXXX FOR AUTHORIZATION FORMS FOR LETTER OF AUTHORIZATION-MEDICAL NECESSITY FOR PRESCRIPTIONS October 2
ICR 201610-1240-004 · OMB 1240-0055 · Object 69059201.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Supporting Statement 1240-XXXX FOR AUTHORIZATION FORMS FOR LETTER OF AUTHORIZATION-MEDICAL NECESSITY FOR PRESCRIPTIONS October 2 |
| Author | Savery, Daniel - OWCP |
| File Created | 2021-01-23 |
| Conversion State | partial |