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Submission Form for Other Payer Requests for Other Payer Advanced APM Determinations (Payer Initiated Submission Form)

ICR 202311-0938-006 · OMB 0938-1314 · Object 137358001.

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Document Metadata
File Typeapplication/octet-stream
File TitleSubmission Form for Other Payer Requests for Other Payer Advanced APM Determinations (Payer Initiated Submission Form)
SubjectSubmission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Subm
AuthorHHS/CMS
File Modified2023-09-27
File Created2023-09-27
Conversion Statecomplete