Document
CA-27, Authorization Request form and Certification/Letter of Medical Necessity for Opioie Medications
ICR 201610-1240-004 · OMB 1240-0055 · Object 69059701.
This document may belong to an older filing. More recent activity for OMB 1240-0055:
Document Viewer [pdf]
Status: Original and derived artifacts are available for this document.
Download: pdf
Loading document viewer…
Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | CA-27, Authorization Request form and Certification/Letter of Medical Necessity for Opioie Medications |
| File Modified | 2016-10-12 |
| File Created | 2016-10-11 |
| Conversion State | complete |