Submitter Application and Instructions

Collection of Encounter Data from MA Organizations, Section 1876 Cost HMOs/CMPs, MMPs, and PACE Organizations (CMS-10340)

OMB: 0938-1152

IC ID: 225026

Documents and Forms

Document Name Document Type
Form CMS-10340 Submitter Application and Instructions Form and Instruction
CMS-10340 CSSC Operations Submitter Application (Form and Instruction) 12_2_2 Submitter Application with OMB [rev OSORA PRA] (4).docx Form and Instruction