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HIPAA ADMINISTRATIVE SIMPLIFICATION (NON-PRIVACY/SECURITY) COMPLAINT FORM

ICR 202606-0938-005 · OMB 0938-0948 · Object 169650401.

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File Typeapplication/octet-stream
File TitleHIPAA ADMINISTRATIVE SIMPLIFICATION (NON-PRIVACY/SECURITY) COMPLAINT FORM
AuthorHHS/CMS
Last Modified ByWriter
File Modified2026-05-13
File Created2026-06-17
Conversion Statecomplete