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Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced APM Determinations (Eligible Clinician I

ICR 202409-0938-018 · OMB 0938-1314 · Object 146536600.

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File Typeapplication/octet-stream
File TitleSubmission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced APM Determinations (Eligible Clinician I
SubjectSubmission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced APM Determinations (Eligible Clinician I
AuthorHHS/CMS
File Modified2023-09-28
File Created2023-09-28
Conversion Statefailed_conversion