CMS-304 Reconciliation of State Invoice (ROSI)

Reconciliation of State Invoice (ROSI) (CMS-304) and Prior Quarter Adjustment Statement (PQRS) (CMS-304a)

CMS Form-304 Reconciliation of State Invoice (ROSI)_07.2021_508

Reconciliation of State Invoice (ROSI) (CMS-304)

OMB: 0938-0676