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Form CMS-10791 Good Faith Estimates Template and Instructions
Requirements Related to Surprise Billing; Part II (CMS-10791)
CMS-10791 - Good Faith Estimate Model Notice Template FINAL 508
Notice of Right to Good Faith Estimate – Health Care Facilities
OMB: 0938-1433
OMB.report
HHS/CMS
OMB 0938-1433
ICR 202303-0938-013
IC 253129
Form CMS-10791 Good Faith Estimates Template and Instructions
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