Document
SBC Template Standard Format-Samoan Translation
ICR 202412-0938-010 · OMB 0938-1146 · Object 150952701.
This document may belong to an older filing. More recent activity for OMB 0938-1146:
Document Viewer [docx]
Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | SBC Template Standard Format-Samoan Translation |
| Subject | Provides a fillable Summary of Benefits and Coverage template to provide answers to key questions and information about common m |
| Keywords | SBC, Summary, of, Benefits, and, Coverage, deductible, services, out-of-pocket, limit, network, provider, referral, specialist, |
| Author | Centers for Medicare and Medicaid Services (CMS) |
| Last Modified By | Writer |
| File Modified | 2024-11-13 |
| File Created | 2026-08-26 |
| Conversion State | complete |