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Participation Exemption Request (PER) Form

ICR 202512-0938-004 · OMB 0938-1066 · Object 164501500.

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Document Metadata
File Typeapplication/octet-stream
File TitleParticipation Exemption Request (PER) Form
Subject2024 participation exemption, annual payment update, HHCAHPS
AuthorCenters for Medicare & Medicaid Services
File Modified2025-10-29
File Created2024-02-26
Conversion Statefailed_conversion