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Submission Form for Other Payer Requests for Other Payer Advanced APM Determinations (Payer Initiated Submission Form)
ICR 202208-0938-004 · OMB 0938-1314 · Object 123867201.
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Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Submission Form for Other Payer Requests for Other Payer Advanced APM Determinations (Payer Initiated Submission Form) |
| Author | CMS |
| File Modified | 2022-07-11 |
| File Created | 2022-07-08 |
| Conversion State | failed_conversion |