Document
Submission Form for Other Payer Requests for Other Payer Advanced APM Determinations (Payer Initiated Submission Form)
ICR 202409-0938-018 · OMB 0938-1314 · Object 146536500.
This document may belong to an older filing. More recent activity for OMB 0938-1314:
Document Viewer [pdf]
Status: No verified local artifact is currently available. The document remains flagged for repair and upstream re-check.
Queue: Repair is queued and waiting for the next worker pass. (priority 20 · next 2026-06-04 19:24:34)
Missing: pdf
No local or Spaces-backed artifact is available yet for this document.
Loading document viewer…
Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Submission Form for Other Payer Requests for Other Payer Advanced APM Determinations (Payer Initiated Submission Form) |
| Subject | Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Subm |
| Author | HHS/CMS |
| File Modified | 2023-09-27 |
| File Created | 2023-09-27 |
| Conversion State | failed_conversion |