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Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Subm

ICR 202509-0938-009 · OMB 0938-1314 · Object 162388301.

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Document Metadata
File Typeapplication/octet-stream
File TitleSubmission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Subm
AuthorHHS/CMS
File Modified2025-08-07
File Created2025-05-21
Conversion Statecomplete