Document
Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced APM Determinations (Eligible Clinician I
ICR 201907-0938-010 · OMB 0938-1314 · Object 93749001.
This document may belong to an older filing. More recent activity for OMB 0938-1314:
Document Viewer [docx]
Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is queued and waiting for the next worker pass. (priority 140 · next 2026-07-12 14:33:37)
Missing: html
Download: Source copy (docx)
Loading document viewer…
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced APM Determinations (Eligible Clinician I |
| Author | CMS |
| File Created | 2021-01-15 |
| Conversion State | partial |