Document
Appendix C1 2023 Eligible Clinician Initiated Submission Form
ICR 202307-0938-005 · OMB 0938-1314 · Object 133385201.
This document may belong to an older filing. More recent activity for OMB 0938-1314:
Document Viewer [docx]
Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is in progress, but the document is still incomplete and remains in the worker queue. (priority 70 · next 2026-06-21 22:25:12)
Missing: pdf, html
Download: Source copy (docx)
Loading document viewer…
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Appendix C1 2023 Eligible Clinician Initiated Submission Form |
| Conversion State | partial |