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Form CMS-10803 Appendix A
Essential Community Provider-Network Adequacy (ECP/NA) Data Collection to Support QHP Certification (CMS-10803)
CMS-10803_Appendix_A_ECP-NA_Template_508
Essential Community Provider and Network Adequacy Data Requirements
OMB: 0938-1415
OMB.report
HHS/CMS
OMB 0938-1415
ICR 202403-0938-012
IC 251109
Form CMS-10803 Appendix A
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1415 can be found here:
2024-08-09 - Revision of a currently approved collection
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