Request of Extension of Time Periods for Extenuating Circumstances

No Surprises Act: IDR Process

CMS-10791 - Appendix 13 Request for Extension Notice

Request of Extension of Time Periods for Extenuating Circumstances

OMB: 1210-0169

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File Title13. Appendix 14-Request for Extension
File Modified2021-12-20
File Created2021-12-13

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