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Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations
ICR 202605-0938-004 · OMB 0938-1314 · Object 168707000.
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Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations |
| Keywords | Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations |
| Author | HHS/CMS |
| Last Modified By | Microsoft® Word for Microsoft 365 |
| File Modified | 2025-12-09 |
| File Created | 2025-05-21 |
| Conversion State | complete |