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Submission Form for Other Payer Requests for Other Payer Advanced APM Determinations (Payer Initiated Submission Form)
ICR 202301-0938-017 · OMB 0938-1314 · Object 128374301.
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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 | 2022-10-28 |
| File Created | 2021-07-09 |
| Conversion State | complete |