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Appendix 6: Certified IDR Entity’s Written Decision of Payment Determination Data Elements
ICR 202204-1545-001CF · OMB 1210-0169 · Object 119921901.
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Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Appendix 6: Certified IDR Entity’s Written Decision of Payment Determination Data Elements |
| Subject | Surprise Billing |
| Author | Employee Benefits Security Administration - United States Depart |
| Last Modified By | Writer |
| File Modified | 2022-03-30 |
| File Created | 2026-10-13 |
| Conversion State | complete |