Document
revised-model-notice-of-adverse-benefit-determination
ICR 202202-1210-006 · OMB 1210-0144 · Object 119692501.
This document may belong to an older filing. More recent activity for OMB 1210-0144:
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 2026-07-21 01:44:31)
Missing: html
Download: Source copy (docx)
Loading document viewer…
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | revised-model-notice-of-adverse-benefit-determination |
| Author | Tamara A. Mihailovic |
| File Created | 2022-05-20 |
| Conversion State | partial |